Intravenous Fluids Flashcards
What are the 3 reasons to give fluids?
Resuscitation, maintenance and replacement
How much fluid should be given in resuscitation?
500ml (250ml in heart failure) of a balanced crystalloid e.g 0.9% saline, over 10 minutes. It is important to reassess the response to treatment.
If you know the patient’s potassium is normal, you can give hartmann’s
What are the average person’s fluid maintenance requirements?
30mmol/kg water
1mmol/kg sodium
1mmol/kg potassium
What is the aim of maintenance fluids?
To replace insensible losses (500ml-1L) and provide sufficient water to excrete 0.5-1.5L urine per day.
What is fluid replacement, and what do you need to know for it?
Restoring not only the body’s daily maintenance requirements but also any ongoing abnormal losses.
Need to know electrolyte content of losses e.g fistula, burns, ileostomy
What are some other ways to give fluids?
Orally e.g with oral rehydration solutions
Via nasogastric tube
Subcutaneous fluids- small volumes only, often in elderly
When should you not give hypotonic fluids?
Increased ICP as can cause cerebral oedema
Liver disease, burns, trauma - volume depletion
Hyponatraemia
Name some side effects of iv fluid use
Hyperchloraemic metabolic acidosis with high anion gap- NaCl
Hyper/hypokalaemia
Allergic reactions
Coagulation disturbance and anaemia- give RBC transfusion in blood loss
Renal toxicity- colloids
Which drug class can cause atypical reactions with colloids?
ACE inhibitors
Name an important reaction with Hartmann’s solution
Hyperkalaemia with spironalactone
Outline the types and amounts of fluid loss from the body
Urine - 0.5-1.5L
Insensible losses from skin and lungs - 500ml to 1L
Faeces - 100ml
“Third space” losses - pleural and peritoneal, abnormal
What are colloids used for?
Volume expansion
