Fluid Management & IV Fluids

Question 1

Type of IV fluid with lower risk of anaphylaxis

Answer 1

CRYSTALLOIDS (NORMAL SALINE, LACTATE RINGERS)

Question 2

Type of IV fluid with higher risk of anaphylaxis

Answer 2

COLLOIDS

Question 3

Blood products (UNITS): infusion rate

Answer 3

to be given over 2-3 hours, slowly

Question 4

HYPOvolaemia (haemorrhage, severe D&V, burns, sepsis)

Answer 4

Acute fluid resuscitation

Question 5

Lower oral intake (bowel obstruction, peri-operative)

Answer 5

Maintenance fluids

Question 6

Resuscitation fluid prescription

Answer 6

SODIUM CHLORIDE (0.9% NaCl) 500mL STAT (over 5-10min) IV

*if elderly/cardiac problems: 250mL

*after fluid resuscitation: reassess the patient (ABCDE)

Question 7

Maintenance fluid prescription: male, 75kg

Answer 7

SODIUM CHLORIDE (0.9% NaCl) 1000mL 115ml/hr IV

DEXTROSE 5% 1000mL (Additive: POTASSIUM CHLORIDE (KCl) 40mmoL) 115ml/hr IV

*infusion rate in Adults = approx. 100ml/hr (40 + weight in kg)

*monitor GBC, U&Es, BP and urine output

Question 8

Maintenance fluid infusion calculation

Answer 8

<10kg: 4ml/kg/hr
until 20kg: 2ml/kg/hr
>20kg: 1ml/kg/hr

eg.: 75kg
10x4 = 40
10x2 = 20
55x1 = 55
total: 40+20+55 = 115ml/hr

Question 9

Maintenance fluid infusion calculation for CHILDREN

Answer 9

<10kg: 100ml/kg/hr
until 20kg: 50ml/kg/hr
>20kg: 20ml/kg/hr

eg.: 24kg
10x100 = 1000
10x50 = 500
4x20 = 80
total: 1580ml/hr

Question 10

Deficit calculation for CHILDREN

Question 11

Resuscitation fluid infusion calculation for CHILDREN

Answer 11

20mL/kg of NS over 5-10min IV