Diagnosis and management of dehydration in children. Children have less fat, more elastic connective tissue, and a pliable skeleton protecting tightly packed abdominal and thoracic structures. Algorithms for iv fluid therapy in children and young. Pdf managing fluids and electrolytes in children is an important skill for pharmacists, who can play an important role in monitoring therapy. Csw maintenance iv fluid management pathway seattle childrens. There is unquestioned need for a current, authoritative text on body fluid physiology, disorders of acidbase equilibrium, and parenteral fluid therapy in children. Hala alnahrain universitycollege of medicine iraqbaghdad. Dec 15, 2009 his new textbook handbook of fluid and electrolytes in pediatrics is to be published by humana press springer. Fluid and electrolyte administration in children sickkids. Intravenous fluid therapy in children and young people in hospital ng29.
Water and electrolyte homeostasis in newborn infants is influenced by numerous factors, including gestational age, postnatal physiological changes in renal function, altered response to hormones, redistribution of total body water, and water loss secondary to environmental factors. The force of an impact is transmitted widely through a childs body, resulting in multisystem injuries in almost 50% of children with. Managing fluids and electrolytes in children is an important skill for pharmacists, who can play an important role in monitoring therapy. Fluid management for the pediatric surgical patient. Second, a team approach involving physicians, nurses, and respiratory therapists is essential. Intravenous fluid guidelines paediatric and neonatal. Fluid management for the pediatric surgical patient powerpoint. Feb 19, 2019 fluid management of the pediatric surgical patient represents an important aspect of medical care, particularly for initial treatment of the ill child. Likewise, it would be optimal to have a brief understanding of the water and electrolyte distribution in children at differs ages. Algorithms for iv fluid therapy in children and young people.
Hyponatraemic seizures respond poorly to anticonvulsants initial management is to give an infusion of 3% nacl sol. For children in body appearance related to the planned cranial surgery. Intravenous fluid management in pediatrics authorstream. Fluid management of the pediatric surgical patient represents an important aspect of medical care, particularly for initial treatment of the ill child. Children with severe dehydration eg, evidence of circulatory compromise should receive fluids iv. Management of acute gastroenteritis, fourth edition summary the infants and children, management of acute gastroenteritis, clinical practice guideline, reflects what is currently regarded as a safe and appropriate approach to the. Maintenance requirements vary depending on the patients. Monitoring fluid and electrolyte therapy is an important role of the pediatric. David is a pediatric nurse in a busy intensive care unit. Maintenance intravenous fluids in children american academy of. Professor, department of pediatrics sapthagiri hospital, bangaluru. Replace deficit boluses 50% over 1st 8 hours, then 50% over next 16 hours.
Perioperative fluid replacement for children and infants is a complex and somewhat controversial topic. Intravenous fluid therapy in children and young people in hospital. The goal of fluid and electrolyte management is to replace losses of water and electrolytes so as to. Incorrect prescription or administration of intravenous fluids has caused harm and deaths in children. Fluid overload in a south african pediatric intensive care. Fluid resuscitation use glucosefree crystalloids that contain sodium in the range 1 154 mmollitre, with a bolus of 20 mlkg over less than 10 minutes for children and young people, and 1020 mlkg over less than 10 minutes for term neonates. The goals of maintenance intravenous fluid management are to preserve adequate effective circulating. Pdf who guidelines on fluid resuscitation in children. Neonatal fluid requirements should be calculated by a neonatologist, since both volume and glucose concentration can vary depending on a neonates clinical condition. Wide practice variation exists in the provision of maintenance fluids for pediatric patients admitted to the general ward. Apr 05, 2014 fluid therapy in paediatrics prepared by. Traditionally, the first step in determining the hourly fluid requirements for a child described by holliday and segar and coined as the 421 rule. Feb 07, 2016 the best seminar in pediatric fluid therapy on slideshare. A free powerpoint ppt presentation displayed as a flash slide show on id.
Consensus guidelines for iv fluid management ucsf benioff. Fluid resuscitation is an integral part of critical care and forms part of many resuscitation guidelines 1, 2. Northern california pediatric hospital medicine consortium. Best practices for iv safety in pediatrics photo courtesy of cardinal every institution caring for neonates, infants, andor children must perform an evaluation of systems and resources utilized in medication use processes. Maintenance therapy replaces the ongoing daily losses of water and electrolytes occurring via physiologic processes urine, sweat, respiration, and stool, which normally preserve homeostasis. Serious morbidity can result from fluid and electrolyte imbalance. Recent literature has emerged in which researchers describe the contextdependent use of ivfs, which should be prescribed, ordered, dosed, and delivered like any other drug. The american academy of pediatrics recommends oral rehydration therapy ort as the preferred treatment of fluid and electrolyte losses caused by diarrhea in children. His new textbook handbook of fluid and electrolytes in pediatrics is to be published by humana press springer. Evidence for technical update of pocket book recommendations. Pdf the world health organization recommendations on management of common childhood illnesses affect the lives of millions of children admitted to. Intravenous fluid therapy is a high risk activity in the paediatric population. Careful fluid and electrolyte management is essential for the well being of the sick newborn infant.
Guidance for fluid requirements for patients over one month of age is outlined in box 1 see pdf. Paediatric intensive care clincial practice guideline fluid therapy introduction. Fluid balance management in pediatric critically ill patients is a challenging task, since fluid overload fo in the pediatric icu is considered a trigger of multiple organ dysfunction. Evidence for recommendations on the choice of intravenous. Children who are unable or unwilling to drink or who have repetitive vomiting can receive fluid replacement orally through. Filston, md division of pediatric surgery and pediatric trauma, department of surgery, university of tennessee medical center, knoxville, tennessee division of pediatric surgery and. Maintenance requirements vary depending on the patients underlying clinical status and setting, especially in postoperative or hospitalized children. Witt l, osthaus wa, bunte c et al 2010 a novel isotonicbalanced solution with 1% glucose for perioperative fluid management in childrenan animal experimental study.
Poor fluid management can result in very devastating results, even death. Demonstrate a thorough understanding of oral rehydration therapy ort by designing a treatment plan to manage, at home, a child with moderate dehydration due to an acute diarrheal illness. He is currently working with jason a 16monthold infant with fluid volume deficiency related to dehydration. If you continue browsing the site, you agree to the use of cookies on this website. Fluids and electrolytes ucsf benioff childrens hospital.
Perioperative intravenous fluid therapy in children. The goal of the pediatric patient assessment process is similar to that of the adult patient. Fluid management and dehydration texas tech university. The normal newborn is particularly prone to developing derangements in fluids and electrolyte concentrations. An understanding of the physiology of fluid requirements is essential for care of these children. Principles of fluid management for paediatric patients. Conventional mechanical ventilation in pediatrics alexandre t.
Fluid management and dehydration national pediatric nighttime curriculum written by dr. Newborn conditions, dysentery, pneumonia, oxygen use and delivery, common causes of fever, severe acute malnutrition and supportive care. A service of the national library of medicine, national institutes of health. Fluid and electrolyte requirements are also influenced by a variety of medical conditions that affect preterm infants e. Ppt fluids and electrolytes in pediatrics powerpoint. Pdf pediatric fluid and electrolyte therapy researchgate. Fluid resuscitationtreatment of dehydration for dehydration,shock,blood lossisotonic normal saline or lactated ringers give 20mlkg as bolus. Critically ill patients usually are admitted with already electrolyte imbalance or conditions where fluid therapy can improve their outcome. Ban slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. By paying close attention to the fluid needs of pediatric patients and monitoring response to fluid therapy, the pediatric pharmacist can have a positive influence on the health of the child.
Paediatric fluid management tutorial for medical s youtube. Standardize care of pediatric patients who require maintenance iv fluids in the hospital. Patient has complex fluid or electrolyte replacement or. Fluid and electrolyte management in the newborn university.
Intravenous fluid therapy in children and young people in. The american academy of pediatrics and the who both recommend oral replacement therapy for mild and moderate dehydration. The goal of fluid therapy is to preserve the normal body water volume and its electrolyte composition. Mph inpatient pediatrics jan 2011 case 2 a 4 year old male presents with a history of vomiting and diarrhea. Fluid management in pediatric patients springerlink. Invasive and noninvasive pediatric mechanical ventilation. Calculation fluid electrolyte management in pediatrics youtube.
Recommendations for management of common childhood conditions. Managing hyponatraemia that develops during intravenous fluid therapy. Intravenous fluid management in pediatrics authorstream presentation. It was research initially performed in the pediatric critical care setting that triggered. Pediatric emergency medicine, dschool of medicine, university of. The causes of catastrophic events, such as cardiac arrest, are. Fluids management and transfusion therapy in pediatrics. Organizing fluid needs into maintenance, deficit, and replacement therapy can provide a systematic, understandable approach to determining fluid therapy.
Algorithms for iv fluid therapy in children and young people in hospital algorithm 2. Look for clinical dehydration and hypovolaemic shock. Use the enteral route for fluid replacement where possible. Smiths anaesthesia for infants and children 7 th edition. The resuscitative phase is the acute presentation window, when ivfs are needed to restore adequate tissue. The goals of maintenance intravenous fluid management are to preserve adequate effective circulating volume, maintain normal electrolytes, and avoid fluid overload. Maintenance fluid requirements are calculated based on a childs body weight. Filston, md, department of surgery, box u11, university of tennessee medical center, 1924 alcoa highway, knoxville, tn 37920 fluid and electrolyte management in the pediatric surgical patient howard c. Aug 21, 2015 how to manage dehydartion in children. Fluid therapy can also have an impact on drug therapy. In the face of significant illness or injury or in the setting of an invasive surgical procedure, fluid balance becomes even more precarious. Fluid management for the pediatric surgical patient powerpoint free download as powerpoint presentation. You can access the worksheet and quiz any time to see how much knowledge you have about fluid replacement in pediatrics.