Fluids Flashcards
What are the main indications of using sodium chloride over hartmans/ compound sodium lactate solution?
Usually in sodium depletion, which can arise from such conditions as
- gastro-enteritis
- diabetic ketoacidosis
- ileus
- and ascites
- And prefered in head injury: hyper-osmolar therefore reduced likelyhood of cerebral oedema
But: risk of hyperchloraemic acidosis
What are usual dails fluid requirements in the adult?
(Volume, Electrolytes and urine output)
Fluids: 25-30 ml/kg water (~2-3L IV)
Electrolytes: 1mmol/kg NA, CL, K+
Urine output: 0.5mg/kg/h
What are contraindications to the administration of Hartman’s?
- Liver failure - cannot metabolise lactate
- Hyperkalaemia - renal failure
What would be a common maintenance fluid prescription for a healthy adult?
Usually 1 salty 2 sweet (some argue 2 salty 1sweet) + Potassium
= 8hrl bags with 20mmol K+ per bag
(in the PSA they usually like 80kg males to 80mmol K+ over 24h)
What is the maintenance requirement of potassium for a patient with a normal potassium level?
Aim for between 40-80 mmol/ day (1mmol/kg/day)
What is the maximum rate of infusion of potassium?
Maximum rate of delivery: 10mmol/h (or 20mmol/h in ICU)
When should you replace potassium orally, and when should you think about IV replacement?
2.6 - 3.4: Oral replacement
if < 2.5: IV replacements
- 40mmol of Potasssium in 1L = 0.3%
- 20mmol of Potassium in 1L = 0.15%
What are some contraindications to thrombophrophylaxis (anticoagulation medicines) in hospital?
Acute bleeding risk (including recent ischaemic stroke)
What are contraindications to compression stockings?
Peripheral arterial disease