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10 Cards in this Set

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Principles of treatment of rehydration
- Provision of maintenance daily fluid and electrolyte requirements
- Plus replacement of deficit fluids and electrolytes
- Plus replacement of ongoing losses
Which solute to use if moderate to severe dehydration?

with hypoglycemia?
LR
NaCl 0,9%

Hypoglycaemia : D10% D5%
Which solute to use if isotonic dehydration
Isotonic dehydration : Na 130-150

NaCl 0.45% D5%
Which solute to use if hypotonic dehydration
Hypotonic dehydration : Na <130

If seizures : NaCl 3% 40 cc/hr

If Na < 130 : D5% NaCl 0,9%
if Na > 130 : D5% NaCl 0,45%
Which solute to use if hypertonic dehydration
Hypertonic dehydration : Na > 150

D5% NaCl 0.2%
Which solute to use if diabetic patient with low glucose
NaCl 0.9% and D50%

Try glucagon injection
Comment déterminer le débit d'administration d'un soluté?
Débit : Besoin d'entretien + Déficit estimé - Bolus donnés + Température

1/2 bolus durant les premières 8 heures et 1/2 durant les 16 heures

1) Besoins d'entretien
règle 4,2,1
premiers 10 Kg = 4cc/kg/h
autres 10 kg = 2cc/kg/h
après 20 kg = 1cc/kg/h

règle 100, 50, 20
0-10 kg = 100cc/kg/24h
10-20 kg = 50 cc/kg/24h
> 20 kg = 20 cc/kg/24h

2) Déficit estimé
DE = 10 x (% dehydration) x poids(kg) / 24

3) Si hyperthermie est surajoutée, on ajoutera environ 7 cc/kg/24 h pour chaque degré d'augmentation de température > 37.5
Boluses

1) Adult
2) Children
Adult : 1-2 L IV
Child : 20 cc/Kg IV x2-3
K requirements?

How to administer potassium?
Child : 2-3 mmol/kg/24 hrs
Adult : 1 mmol/kg/24 hrs

Potassium is always administered in an infused solution, never in a bolus.

Maximum 40 mmol/L
Common IV fluids in children and neonate
First month of life : D5W + 0.2 NS + 20 mEq KCl/L

Children : D5W + 0.9 NS + 20 mEw KCl/L