#SANJAY PANDYA FLUID THERAPY PDF SERIAL#
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For children with mild or moderate dehydration, enteral (oral or NG) rehydration is preferable. Give a bolus of 10вЂ“20 mL/kg of sodium chloride 0.9% as fast as possible, and reassess to determine if additional IV fluid is requiredДo not include this fluid volume in subsequent calculationsДЄlternative resuscitation fluids such as Plasma-Lyte 148, Hartmann's, packed red blood cells, or albumin may sometimes be used on senior advice RehydrationДegree of dehydration must first be calculated. Treat shock with bolus IV fluids to restore circulatory volume: Resuscitation: Care of the seriously unwell child Also document intake/inputs and ongoing losses (including urine output), with at least 12 hourly subtotals

Repeated weights are the best measure of fluid status.

For more unwell children and children with large fluid losses or abnormal electrolytes, check the electrolytes and glucose 4-6 hours after starting fluid therapy, and then according to the clinical situation.

All children should have serum electrolytes and glucose checked before starting IV fluid treatment and at least every 24 hours if IV fluids are continued at more than 50% maintenance.

Children with severe dehydration or ongoing losses need to be weighed more often.

All children on IV fluids should be weighed at the start of treatment and then at least daily.

Signs of fluid overload including oedema (eg periorbital, genital, sacral, peripheral) should also be evaluated, especially in children already receiving IV fluid treatment.

Situations where specialised fluid management is requiredВ (see list above).

Short gut or other significant gastrointestinal pathology.

Consider increased antidiuretic hormone (ADH) secretion - especially with acute CNS and pulmonary conditions, although any unwell child is at risk.

Hypernatraemia and notify senior clinician

Check the compatibility of IV fluid with any IV drugs that are being co-administeredДЎ45 mmol/L (or significant change of >0.5 mmol/L/hr on a repeat measure) вЂ“ see.

See flowchart outlining approach to safe IV fluid prescription

Safe use of IV fluid in children requires careful prescribing and monitoring.

Fluids with a similar sodium concentration to plasma are most appropriate.

Whenever possible the enteral route should be used

This guideline only applies to children aged 1 month to 18 years who cannot receive enteral fluids.

#SANJAY PANDYA FLUID THERAPY PDF SERIAL#

Serial weights are the best measure of acute changes in fluid status.

#SANJAY PANDYA FLUID THERAPY PDF FULL#

Most sick children will retain water and require less than full maintenance fluids.In most situations, the preferred fluid type is sodium chloride 0.9% (with glucose 5% +/- potassium for maintenance fluid).

Whenever possible, the enteral route should be used.

Inborn errors of metabolism (known or suspected).

Severe electrolyte disturbances, including.

Resuscitation: Care of the seriously unwell child Dehydration Maintenance Fluids Calculator Follow specialised fluid guidance for: IV fluids - for children beyond the newborn period See also

Sanjay pandya fluid therapy pdf