Preoperative fluid therapy

Question 1

When are fluids given?

what to examine

Answer 1

just prior to induction

• need to examine blood pressure drop, jvp, resp and pulse volume
• sometimes need invasive monitoring - eg central venous pressure or pulmonary capillary wedge pressure - normal saline used to increase fluids

Question 2

diff fluids for diff things

Answer 2

low volume - saline
low gluocose - 10% dextrose
Blood giving - plasmalyte (cannot use dextrose cannot mix with blood bank products)
normal - saline
long procedure - plasmalyte
autonomic blockade - give vasoconstrictor rather than fluid

Question 3

pulses paradoxus

Answer 3

-when bp decreases more than 10mmhg in inspiration

Question 4

good measure of perfusion

Answer 4

uring output >1ml/kg and absesnce of pulsus paradozus

Question 5

what to do if volume gets low ?

Answer 5

can give 5ml/kg of appropriate fluid over 10 minutes and assess rise in BP
-if it goes up high - hypervolaemic, if it goes up less - hypovolemic