Vn117 2014

FLUID THERAPY

1. To provide and maintain daily maintenance fluid requirements.

 

2. To correct dehydration by supplying fluid deficit.

 

3. To replace essential electrolytes.

 

4. To provide a vehicle for intravenous medications

5. In emergency fluid or blood replacement following shock or haemorrhage.

 

6. To control hypovolaemia and maintain blood pressure during surgery.

 

REASONS FOR FLUID THERAPY

ICF (40% of BWT) ECF (20% of BWT)

Intersitial fluid Plasma

15% BWT 5% BWT

FLUID COMPOSITION OF THE BODYTOTAL BODY FLUID =60% OF BWT

• Per os• S/C• I/P• I/V• I/O

• Only I/V and I/O suitable for severe shock or dehydration

ROUTES OF FLUID ADMINISTRATION

• Accessible veins in different species• Avoidance of damaged veins, phlebitis or veins that

would cause catheter flexion as joints move• Duration of catheterisation

• Limb catheters are less likely to cause serious complications but jugular catheters are well tolerated and may be suited to chondrodystrophic dogs and mobile patients that tend to tangle limb catheters

FACTORS AFFECTING THE CHOICE OF VEIN

IV CATHETERS

BUTTERFLY CATHETERS

OVER THE NEEDLE CATHETERS

Seddinger over the wire catheter

JUGULAR CATHETERS

PEEL AWAY CATHETERS

Gauge

Should be the largest that does not cause damage to the vein or thrombosis due to inadequate flow past the catheter

Catheter length

Longer is more stable but it must not be so long it kinks at the flexion of a joint or enters the heart

CATHETER GAUGE AND LENGTH

standard surgical prep required for the site and administrator hands

avoid clipper burn and ensure the site is dry before placement

PREP OF THE SITE

60 drop per ml sets should be used for patients under 10kg

Paediatric burettes can be inserted in the line for accurate delivery of small volumes

Plugs 3 way taps and t-port connectors can be used to allow the set to be disconnected at times

FLUID SETS

Use page 6 of your notes to make a poster about safety and trouble shooting the drip

SAFETY PRECAUTIONS AND TROUBLE SHOOTING THE

DRIP

Chrystalloids

• Isotonic• 0.9%saline, LRS/hartmanns

• Hypertonic• 7%saline solution

• crenation

• Hypotonic • 5% dextrose in water

• haemolysis

Colloids

• Used to correct hypovolaemia /hypoprotienaemia

• Tend to cause platelet and clotting function problems

• Dextran and hetastarch

CHOICE OF FLUIDS

• Physical exam observations can give an estimate of hydration status to use in calculation of fluid deficit/rehydration volume required

• Or• PCV can be used to evaluate the fluid deficit

• Maintenance fluid can be estimated at 50 mls/kg /day

• Ongoing losses are estimated from observed losses from vomiting diarrhoea and extra urinary losses due to the disease condition

PATIENT ASSESSMENT AND CALCULATION OF FLUID REQUIRED

• Monitor for over infusion, phlebitis, fluids that have stopped flowing, infection and correct placement of the catheter in the vein

MONITORING THE DRIP