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Emergency > Fluids > Flashcards

Fluids Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

What makes up the total body fluid?

A
  • Intracellular fluid

* Extracellular fluid

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2
Q

Where can you lose fluid in your body?

A
  • Kidney
  • GI tract
  • Lung
  • Skin
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3
Q

What is the ratio of fluid between intracellular and extracellular fluid?

A

2/3 intracellular (25L) and 1/3 extracellular (15L)

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4
Q

What makes up extracellular fluid?

A
  • Intravascular (20%)

* Interstitial (80%)

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5
Q

What are the anion and cation concentrations in extracellular fluid?

A
  • Na+ 145
  • K+ 4
  • Cl- 115
  • Ca2+ 2.5
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6
Q

What are the anion and cation concentrations in intracellular fluid?

A
  • Na+ 12
  • K+ 155
  • Cl- 4
  • Ca2+ <0.5
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7
Q

What is albumin and its purpose considering osmotic gradients?

A

Main protein within plasma which maintains osmotic gradient keeping H20 within vessels

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8
Q

What are the main crystalloid fluids that can be given?

A
  • 5% dextrose
  • Dextrose saline 4%
  • Hartmann’s solution
  • 0.9% Saline
  • 0.45% Saline
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9
Q

What is the electrolyte content of 5% dextrose?

A

0 Na+
0 Cl-
0.4 K+

!50g glucose!

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10
Q

What is the electrolyte content of dextrose saline 4% / 0.18%?

A

30 Na+
30 Cl-
0.4 K+

!40g glucose!

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11
Q

What is the electrolyte content of Hartmann’s solution?

A 
131 mmol/L Na+ 
111 mmol/L  Cl-
5 mmol/L K+ 
2 mmol/L Ca2+
29 mmol/L Bicarbonate

In a 1 litre bag

!Closest physiological fluid!

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12
Q

What is the electrolyte content of 0.9% saline?

A

154mmol/L Na+
154mmol/L Cl-
in a 1 litre bag

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13
Q

What are indicators that a patient may need fluid resuscitation?

A
  • Systolic BP <100mmHg
  • HR >90bpm
  • Cap refill >2seconds / peripheries cold to touch
  • Resp rate >20breath per min
  • NEWS >/= 5
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14
Q

What is meany by fluid resus?

A

*Give a fluid bolus of 500ml 0.9% sodium chloride over less than 15minutes

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15
Q

When should maintenance fluids be given?

A

When a patient cannot meet their fluid or electrolyte needs orally or enterally and they do not have a complex need or issues

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16
Q

What are normal daily fluid and electrolyte requirements?

A
  • 25-30ml/kg/24hrs of water
  • 2mmol/kg/24hrs of sodium,
  • 1mmol/jg/24hrs potassium and chloried
  • 50-100 g/2hrs of glucose (e.g. glucose 5% contains 5g/100ml)
17
Q

How should maintenance K+ be given in 24hr period?

A
  • Requirement is 1mmol/kg/day of K+
  • Potassium prescriptions should be rounded to the nearest common fluid available i.e. 67kg person should have fluids containing 20mmol and 40mmol of K+ in 24hour period
18
Q

What mmol of K+ can you prescribe in a bag or fluids?

A

Bags that contain KCl saline are available and they typically contain 20 or 40mmol of K+ in a 1litre bag

19
Q

What are crystalloid fluids?

A

Fluids that contain small molecules that can easily cross cell membranes i.e. electrolytes

20
Q

What are the 3 main types of fluids?

A
  • Crystalloids
  • Colloids
  • Blood products
21
Q

What are examples of crystalloids?

A
  • 0.9% sodium chloride
  • Hartmanns solution
  • 5% dextrose (glucose)
22
Q

What are colloids?

A
  • They have large molecule like gelatin in them
  • Thought to expand the intravascular space
  • Use is decreasing in favour of crystallloids
23
Q

What are examples of colloids?

A
  • Isoplex

* Volplex

24
Q

What are the types of blood products?

A
  • Packed red cells
  • Platelets
  • Fresh frozen plasma
25
Q

Why can K+ not be given quickly?

A

Can have adverse affects on the heart

26
Q

What is typically the maximum rate you can deliver K+?

A

10mmol/hr

27
Q

What does typical a adult weighing 60-70kg require a rate of maintenance fluids of?

A

Approx 100mls/hr
i.e 2.4L over 24hrs
May require more if additional fluid losses

28
Q

What should be monitored when using IV fluids?

A

U&Es so you can adjust fluid electrolyte content accordingly

Emergency (16 decks)

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