Fluid
Clinical findings
100

When do you use crystalloids vs colloids

Crystalloids - for resuscitation and routine maintenance (different ones for each)

Colloids - blood products → used if they have major blood loss

100

What are the 5 R's

Resuscitation

Routine maintenance

Replacement

Redistribution

Reassessment

200

Give 2 ways to assess the fluid status of patient

Fluid input-output chart

Daily weight chart

U&Es

200

Give me 3 findings of hypovolaemia

•Cool peripheries

Prolonged capillary refill time

Increased RR

Decreased BP

Non-visible JVP

Dry mouth

Weight gain

Decreased urine output

300

What fluid compartments is fluid found in

ICF (2/3)

ECF (1/3) -> intravascular space, interstitium, transcellular fluid

300

Give me 4 findings of hypervolaemia

  • HTN
  • Elevated JVP
  • Increased urine output
  • Abdominal distension (ascites) and peripheral oedema
  • fluid chart showing positive fluid balance
  • Weight gain
400

Give 3 examples of crystalloids

Give 3 examples of colloids

Crystalloids

NaCl or Hartmann's or Dextrose or Ringer’s Lactate or Plasma-Lyte …

Colloids

Human albumin or packed red cells or platelets or fresh frozen plasma or cryoprecipitate


400

How do you prescribe resuscitation fluids

500ml bolus of crystalloid solution over <15 mins

Reassess patient using ABCDE to look for ongoing hypovolaemia - if still ongoing then give further 250-500ml bolus of crystalloid solution

Then reassess again and repeat this process until 2L of fluid and if they still havean ongoing need seek expert help

500

Why do you need to give fluids to a septic patient

  • In septic patients the tight junctions between capillary endothelial cells break down and vascular permeability increases
  • This causes hydrostatic pressure to increase and reduces oncotic pressure = fluid leaving the vasculature and enters the tissue
  • So we need to give relatively large volume of IV fluid to maintain intravascular volume even though total body water may be high → close monitoring of fluid balance is needed
500

What is the daily requirements of water, Na+, K+ and glucose

  • Water = 25 ml/kg/day
  • Na+ = 1.0 mmol/kg/day
  • K+ = 1.0 mmol/kg/day
  • Cl- = 1.0 mmol/kg/day
  • Glucose = 50-100g/day (prevents starvation ketosis)
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