Fluids

Question 1

Emergency resuscitations for shock (low BP (S<90, D<60) and tachycardia)?

Answer 1

0.9% Sodium Chloride
500ml over <15 mins

• no KCL

Question 2

Emergency hypoglycaemia?

Answer 2

Glucose 10%
150ml over <15 mins

OR
Glucose 20%
75ml over <15 mins

• no KCL

Question 3

Emergency hypercalcaemia?

Answer 3

0.9% Sodium Chloride
1000ml over 4 hours

• no KCL

Question 4

Emergency hyperkalcaemia?

Answer 4

ACTRAPID

10 UNITS IN 100ML OF 20% DEXTROSE, OVER 30 MINS

Question 5

Routine maintenance requirements?

Answer 5

25-30ml/kg/day of water
1mmol/kg/day of K+, Na+, Cl-
50-100g/day of glucose

Elderly - approx 2L per day
Adults - approx 3L per day

Question 6

Example maintenance fluid - with NaCl and patient requires 40mmol/L?

Answer 6

0.9% sodium chloride with 0.3% (40mmol/L) Potassium Chloride

1000ml over 8-12 hours

Question 7

Example maintenance fluid - with glucose and patient requires 20mmol/L?

Answer 7

5% glucose with 0.15% (20mmol/L) Potassium Chloride

1000ml over 8-12 hours

Question 8

Fluid deficit

Answer 8

It is likely there is going to be a need for >3L of water per day, so it is likely you will need 1000ml over <6 hours:

0.9% Sodium Chloride with 0.3% Potassium Chloride (40mmol/L)

1000ml over 4-6 hours