Fluids Flashcards
Give all patients 0.9% saline UNLESS
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
How much fluid:
Tachycardic or hypotensive
500 mL bolus
250 mL if HF
How much fluid:
Only Oliguric
1L over 2-4hr
How fluid depleted is someone who is:
Oliguric/anuric
500 mL
How fluid depleted is someone who is:
reduce urine output AND tachycardic
1L
How fluid depleted is someone who is:
reduced urine output
tachycardic
Shocked
> 2L
Maintenance fluid for adults
3L/24 hours
8 hourly
Maintenance fluid for elderly
2L/24 hours
12 hourly bags
The volume of NaCl and dextrose needed to provide adequate nutrition
2L 0.9% NaCl
1L 5% dextrose
2 salty 1 sweet
Maintenance potassium requirements
40 mmol KCl per day if potassium levels are normal (when NBM)
IV potassium should not be given more than 10 mmol/hour
Maintenance water requirements
25-30 mL/kg/day
Maintenance K Cl Na requirements
1 mmol/Kg/day
Maintenance glucose (in NBM)
50-100 g/day
NICE guidelines for maintenance fluids
dex saline + 27 mmol/L KCl
Fluids in the hypotensive patient
500 mL crystalloid with 130 to 154 mmol/L Na
Over <15 minutes
Monitor response
Fluid for resuscitation in patients with severe sepsis
Human Albumin Solution 4-5%
Fluid requirement for frail/elderly
20-25 mL/kg/day
Maximum K concentrations
should not exceed 40 mmol/L
Resuscitation fluid for children/adolescents
glucose-free crystalloid containing 131-154 mmol/L sodium over 10 minutes
Resuscitation volume for children/young people
20 mL/kg
Resuscitation volume for term neonates
10-20 mL/kg
Strictly contraindicated in children
sodium chloride 0.18% with glucose 4%
Fluid volumes for children
100 mL/kg for the first 10 kg then 50mL/kg for the next 10 kg then 20 mL/kg for the remaining weight
Starship recommendation for resus fluids
10 mLs/kg 0.9% saline as a bolus
