Dehydration and IV fluid Calculations | Western Sydney University

University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

69

Pages:

4
Author:

Mariam A. A.

Dehydration and to fluid Calculations * weight loss from a recently well child weight is the most objective measure of dely ration * Classification of dehydration severity Mild <5% Moderate 5-9% Severe 7,10% * alest * lethargy/irritability *HOTN * nam HR *19 HR * consciousness * moist membranes + RR *THR↑ RR * eyes Prontanelles * suken eyes? hoantonelles * apneic breaking not succes * dy mucus memtorons *pale or mottled * instant skin recoil * skin turgor * cold peripheries * CRT * eyes & Prontanelle deeply sucker * skin turgar * dry mucus membrail MT CRT MAINTENANCE FLUID CALCULATIONS HOURLY 4:2:1 Rule *4m2s/kg/hr for 1st 10kg *2mls/kg/hr for and 10kg * ImL/kg/hr for additional kg DAILY 100. 80:20 Rule *100 m2/kg/24hr for 1st 10 kg * 80 m² llcg/24 hr for 2nd 10kg * 20 mL/kg/24 hr for each additional lag 2/3rd SIADH → so that they don't get hyponatremia TYPES OF FLUID *09% NaCl½ 8% Glucose *0.9% Nacl½ 8% Glucose + 20 mMol/L KCI, Gk for same risk се NEUER FORGET GLUCOSE * normal saline for bolus ory NORMAL VALUES *Nat135-145 mmol/L 3.5 S.S mmol/ *HCO322-30 * ladate (2 * Urea's Or are age dependent CI 97 COS mmol/L *BE -3 to +3 IVI *Nat Glucose absorption are linked * Gastrolyte Na 60 mmol/L K 20 mmol/L Glucose 90 mmol/L * Hydralyte Na 45 mud/L k mmol/L 20 Glucore 80 mmol/2 RESUSCITATION FLUID *0.9% NaCl 10-20 ml as fast as possilole & then reasses to determine if need more IV fluid * consider 10mL/kg warmed blood in trauma (packed cells) REHYDRATION FLUID CALCULATIONS use same type of fluid as for maintenance * rehydration rate Ihr = child weight x dehydration % x10 24 * total fluid rate = Maintaintance rale/hr + rehydration rate/hr * give up to 5% nehydration every 24hrs * reassess with clinical examination +/-blood tests every 6-8 his RESUS Baus of 0.9% nam salire 20mlky Cive colus op dextrose 20 ml/kg (10%) FLUID DEFICIT CALCULATIONS Oeficit (ml) = C Pre-morbid weight (kg) - current weight (kg)Jx1000 if pre-morbid weight not available ↓ weight Ucg) - delicit % x 10 TOTAL FLUID REQUIREMENT Total fluid replacement = maintance + replacement delicit + replacement of ongoing losses IMPORTANT CONSIDERATIOUS * all children on iv fluids should be weight @start of to theun@lecast daily →childres with severe dellkydration on ongoing losses need to be weighed mare often * all children should have their electrolytes 3 glucose checked * the preferred maintenance in fluid is NaCl 0.9% with 5% glucore Glucose * mostly 5% * 10% mostly used in infants * 10-15%-very occassicmally in neonates children with metablic disorders *> 20% rovely used in chilkhes Cinapproriale used can lead to adverse events ONLY USE IN ICU SETTING Rehydratican = weight (mg) x delicit % x10 if 5% put as 0.05 * Hyver namenic dehydration= rate over 48 his caim to reduce velydrate 4 mmol every 6hN nestore circulating volume cueck electrolytes every this & adjust rate as мебет