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Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2

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Nội dung chi tiết: Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2

Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2

Chapter 4Intravenous fluid therapy in medical patientsINTRODUCTIONTie optimal fluid management of medical patients is of great importance and is often

Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2n poorly managed. The role of the physician in accurately assessing fluid status, losses and requirements is critical.Medical patients can present wit

h multiple co-morbidities that make fluid management challenging, for example the septic patient with congestive cardiac failure (CCF).Medical wards c Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2

annot provide the invasive monitoring and high staff to patient ratios that are found in an intensive therapy unit/high dependency unit (ITƯ/HDƯ) envi

Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2

ronment and some patients may not be appropriate for escalation to these levels of care. Tiis means that good clinical fluid assessment, scrupulous fl

Chapter 4Intravenous fluid therapy in medical patientsINTRODUCTIONTie optimal fluid management of medical patients is of great importance and is often

Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2ravenous fluid (I VF) therapy are often far from routine - do not hesitate to seek senior or specialist advice, for which this chapter is no substitut

e.74 Making Sense of Fluids and ElectrolytesREMEMBER0/”■> Maintenance fluids in medical patients'Doctor, could you just come up to the ward to write u Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2

p some fluids?'Prescribing maintenance intravenous fluids should not be considered a robotic or routine task; it is the same as prescribing medication

Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2

. Careful assessment of fluid status and exacting fluid prescription is of paramount importance, as is checking the patient's most recent blood result

Chapter 4Intravenous fluid therapy in medical patientsINTRODUCTIONTie optimal fluid management of medical patients is of great importance and is often

Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2te requirements, recent U+Es•Any special considerations from their medical historyAim to encourage oral intake as much as possible.MEDICAL CONSIDERATI

ONS IN FLUIDASSESSMENT AND MANAGEMENTTo cover both urine output and insensible losses, healthy adults require around 30-40 mL/kg of water over 24 hour Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2

s. This equates to 2-2.5 L of fluids/day in a 70-kg adult, ’lhese requirements will be different in some groups of patients, for example those in rena

Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2

l failure or the frail elderly. This is discussed in detail in the sections that follow.No fluid balance available:•Estimated maintenance from weight•

Chapter 4Intravenous fluid therapy in medical patientsINTRODUCTIONTie optimal fluid management of medical patients is of great importance and is often

Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2hart•Estimate insensible losses (0.5-1.5 L/24 hours)Intravenous fluid therapy in medi Once the fluid requirements are known they can be written up as

500-and 1000-mL bags at the appropriate rate. Do not forget to factor in oral intake. Where it is safe to do so, prescribe fluids so that they will ru Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2

n out during the next working day so that the team looking after the patient can reassess.Table 4.1 A guide to clinically estimating fluid deficitFlui

Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2

d deficitMildModerateSevereHeart rate (HR) Blood pressure (BP)Normal (N) N>100 N SBP < 20 mmHg decrease DBP < 10 mmHg decrease>120 SBP > 20 mmHg decre

Chapter 4Intravenous fluid therapy in medical patientsINTRODUCTIONTie optimal fluid management of medical patients is of great importance and is often

Ebook Making sense of fluids and electrolytes - A hands on guide: Part 2LREMEMBER

Chapter 4Intravenous fluid therapy in medical patientsINTRODUCTIONTie optimal fluid management of medical patients is of great importance and is often

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