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7 Cards in this Set

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SN (5)

-auscultate chest for fines bilateral crackles continuous reassessment before and after fluid admin


-titrate to pt response HR<100 BP>100


-don't delay Tx, IV en route


-consider TPT in chest injury not responding to fluid


-Haemorrhage from blunt trauma not considered as uncontrolled

Clinical signs of dehydration (6)


-postural perfusion changes including tachycardia, hypotension or dizziness


-decrease sweating and urination


-poor skin turgor, dry mouth, dry tongue


-fatigue and altered consciousness


-evidence of poor fluid intake compared to fluid loss


-dehydration in the hyper glycaemic pt Mx with this CPG



Modifying factors (4)

Complete spinal cord transection Rx as per Spinal Injury CPG


-pt with insolate neurogenic shock can be given up to 500mL NaCl bolus to correct hypotension and no further fluid if SCI is the sole injury


Chest injury


-consider TPT Rx as per Chest Injury CPG


Penetrating trunk injury, aortic aneurysm or uncontrolled haemorrhage


-accept palpable carotid pulse and Tx


GI haemorrhage


-consider less fluid vol and accept BP 80-100

HR <100 and BP >100 Mx

-consider modifying factors


-auscultate chest


-fluid not required unless signs of dehydration


then give NaCl up to 20mL/kg IV over 30/60

HR >100 and BP>100 Mx


isolated tachycardia


-consider modifying factors


-auscultate chest


-NaCl 20mL/kg IV


-auscultate chest


-repeat NaCl 20mL/kg IV if HR >100


-after 40mL/kg consult and if unavailable auscultate chest and repeat NaCl 20mL/kg IV

BP <100 Mx

-consider modifying factors


-auscultate chest for bilateral fine crackles


-NaCl 20mL/kg IV


HR<100 and BP>100


-no further fluid reassess and Tx


HR>100 and/or BP <100


-insert second IV


-auscultate chest


-repeat NaCl 20mL/kg IV


BP remains <100


-consult and if unavailable auscultate chest and repeat NaCl 20mL/kg IV