Fluid Prescribing Flashcards
5 uses of fluids?
resuscitation replacement routine maintenance redistribution reassessment
general management of hemodynamically unstable patient (fluid resuscitation)?
fluid bolus of 500ml (crystalloid) over 15 mins
then reassess (ABCDE)
if still unstable give more boluses up to 2-2.5L
general rule for routine maintenance fluids?
25-30ml/kg water
1mmol/kg/day sodium, potassium and chloride
50-100g/day glucose
general rules for replacement and redistribution fluids?
add or subtract from routine maintenance, adjusting for all other sources of fluid and electrolytes
what type of fluids used in resuscitation?
crystalloid (not colloid)
- eg hartmanns
why is saline not recommended in resuscitation?
excessive amounts can cause hyperchloraemic metabolic acidosis
(can be used in cases of rhabdomyolysis)
examples of crystalloids?
0.9% saline
hartmanns (balanced crystalloid)
dextrose
what type of fluids are used in replacement?
balanced crystalloid (eg hartmanns) crystalloid (eg saline)
what fluids are used for routine maintenance?
0.18% NaCl/4% dextrose
0.45% NaCl
5% dextrose
when might human albumin solution be used?
only really in severe sepsis
whats included in fresh frozen plasma?
includes everything inside the plasma (clotting factors, proteins, antibodies)
what are PRCs?
packed red blood cells
what is included in cryoprecipitate?
mainly clotting factors
generally used to reverse severe clotting abnormalities and treat large haemorrhages
at what blood pressure are resus fluids required?
<90/60
when is albumin given?
liver failure
