Prescribing IV Fluids and Blood products Flashcards
1A and 5Rs approach to fluids
assessment resuscitation routine maintenance replacement redistribution reassessment
Exam findings suggesting fluid deficient (7)
RR >20 HR >90 pulse thready dry membranes loss of skin turgor SBP <100 CRT >2s
what does increased JVP suggest about fluid balance?
Fluid overload
Resuscitation fluids
500ml bonus of sodium chloride 0.9% over 15mins
when should you involve ITU if using fluids for resuscitation
when 2L used
or 1L if old/frail/CCF
which fluid should be used for maintenance fluids?
sodium chloride 0.18% in 4% glucose
calculating maintenance fluids amount
25-30ml/kg/day water and 1mmol/kg/day of potassium/sodium/chloride
how much glucose a day should you have in fluid to limit starvation ketosis?
50-100g/day
how much fluid do most patients require over 24hrs?
not more than 3L
reasons for water loss (7)
fever hyperventilation pancreatic drain inappropriate urinary loss vomiting NG tube loss diarrhoea
fluid redistribution issues (6)
gross oedema severe sepsis hypo/hypernatraemia renal/liver/cardiac impairment post-op retention malnourished
what should you give to treat hyperkalaemia?
calcium gluconate/chloride
IV dextrose and insulin
treating mild transfusion reaction
stop transfusion
assess parameters
can continue at reduced rate
monitor carefully
managing moderate transfusion reaction
urgent review
can consider restart with antihistamines and anti-pyretic
managing severe transfusion reaction
stop and disconnect transfusion, give IV fluids etc
