What Fluid To Give?

Question 1

In fluid resus, what do we give first?

Answer 1

0.9% NaCl or Hartmann’s 500ml over 15mins

Question 2

After the first fluid resus what do we do?

Answer 2

Reassess, repeat with 250-500ml if necessary

Question 3

Post fluid resus, once patient is stable, what must we consider?

Answer 3

Need for water and electrolytes

Question 4

Routine maintenance values in patients with normal renal function

Answer 4

Water: 25-30ml/kg/day
Sodium: 1mmol/kg/day
Potassium: 1mmol/kg/day

Subtract other sources of fluid

Question 5

What do we also give to patients with no calorific intake per day that are not at risk of refeeding syndrome?

Answer 5

50-100g/day

Question 6

When might you get electrolyte rich losses?

Answer 6

Drains, stomas, diarrhoea and vomiting

Question 7

What to replace when you have lost Gastric fluid?

Answer 7

0.9% NaCl

Potassium

Question 8

What to give when you lose fluid distal to stomach?

Answer 8

Hartmann’s and potassium

Question 9

What to do with polyuria?

Answer 9

Seek specialist advice

Question 10

What results in free water loss and what do we give for this?

Answer 10

Fever and tachypnea

500ml/day of 5% glucose to help draw water into cells

Question 11

What type of fluid do we use in a simple acute fluid deficit?

Answer 11

Isotonic fluid