Fluids

Question 1

Give all patients 0.9% saline UNLESS

Answer 1

1) hypernatraemic, hypoglycemic: give 5% dextrose
2) Has ascites: Give human albumin solution
3) Is shocked with BP <90: Give colloid
4) Is bleeding: Give blood/colloid

Question 2

How much fluid:

Tachycardic or hypotensive

Answer 2

500 mL bolus

250 mL if HF

Question 3

How much fluid:

Only Oliguric

Answer 3

1L over 2-4hr

Question 4

How fluid depleted is someone who is:

Oliguric/anuric

Answer 4

500 mL

Question 5

How fluid depleted is someone who is:

reduce urine output AND tachycardic

Answer 5

1L

Question 6

How fluid depleted is someone who is:
reduced urine output
tachycardic
Shocked

Answer 6

> 2L

Question 7

Maintenance fluid for adults

Answer 7

3L/24 hours

8 hourly

Question 8

Maintenance fluid for elderly

Answer 8

2L/24 hours

12 hourly bags

Question 9

The volume of NaCl and dextrose needed to provide adequate nutrition

Answer 9

2L 0.9% NaCl
1L 5% dextrose
2 salty 1 sweet

Question 10

Maintenance potassium requirements

Answer 10

40 mmol KCl per day if potassium levels are normal (when NBM)
IV potassium should not be given more than 10 mmol/hour

Question 11

Maintenance water requirements

Answer 11

25-30 mL/kg/day

Question 12

Maintenance K Cl Na requirements

Answer 12

1 mmol/Kg/day

Question 13

Maintenance glucose (in NBM)

Answer 13

50-100 g/day

Question 14

NICE guidelines for maintenance fluids

Answer 14

dex saline + 27 mmol/L KCl

Question 15

Fluids in the hypotensive patient

Answer 15

500 mL crystalloid with 130 to 154 mmol/L Na
Over <15 minutes
Monitor response

Question 16

Fluid for resuscitation in patients with severe sepsis

Answer 16

Human Albumin Solution 4-5%

Question 17

Fluid requirement for frail/elderly

Answer 17

20-25 mL/kg/day

Question 18

Maximum K concentrations

Answer 18

should not exceed 40 mmol/L

Question 19

Resuscitation fluid for children/adolescents

Answer 19

glucose-free crystalloid containing 131-154 mmol/L sodium over 10 minutes

Question 20

Resuscitation volume for children/young people

Answer 20

20 mL/kg

Question 21

Resuscitation volume for term neonates

Answer 21

10-20 mL/kg

Question 22

Strictly contraindicated in children

Answer 22

sodium chloride 0.18% with glucose 4%

Question 23

Fluid volumes for children

Answer 23

100 mL/kg for the first 10 kg then 50mL/kg for the next 10 kg then 20 mL/kg for the remaining weight

Question 24

Starship recommendation for resus fluids

Answer 24

10 mLs/kg 0.9% saline as a bolus