Principles of IV Therapy

Question 1

What is the preferred fluid type in most situations?

Answer 1

0.9% sodium chloride

With glucose 5% +/- potassium for maintenance fluid

Question 2

Explain the 4-2-1 rule for fluid prescribing

Answer 2

4mL/kg/hr for first 10kg
2 mL/kg/hr for next 10kg (11-20kg)
1mL/kg/hr thereafter (>20g)

Question 3

Maintenance rate for fluids for 27kg child

Answer 3

67mL/hr

Question 4

Why should 2/3 maintenance fluids be used in most unwell children?

Answer 4

To avoid water overload and hyponatraemia (unwell children are likely to secrete excess ADH - particularly those with CNS or pulmonary conditions, or in the case of trauma or post-operative care)

Question 5

Alternative maintenance fluid options

Answer 5

PlasmaLyte 148 with glucose 5%

Hartmanns with glucose 5%

Question 6

Calculating volume of fluid bolus

Answer 6

10-20mL/kg of 0.9% sodium chloride

Can repeat up to maximum of 40mL/kg