I am about halfway through an AEMT class, so with that being said I’ll probably understand more of this once class is over, but I’ve been thinking about this. So with IV fluids, although it’s a fairly simple thing, there are a lot of different indications and dosages for different things, compared to most other drugs it’s kinda clear cut. It can also obviously have some detrimental effects if given improperly. I guess my biggest thing is when do you give them in certain situations, and at what rate? I mean I know there’s the standard 20ml/kg rule, but does that always apply? I feel like nobody really uses that. Then there is maintaining radial pulses or 90 systolic in trauma. When does that apply? Also how do you determine drip rate? I know you can do TKO or wide open, but when does it fall in the middle of those? Does anyone have like a guide type thing I can use, or can anyone explain it better? In the real world how are these things determined?
IV fluid guide
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TKO and Titrate to effect.
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Real-world? You're looking for shock states. If you see shock or impending shock, you're probably going to be giving volume. For that, you're going to be doing 20 or 30 ml/kg. That can be a LOT of fluid. If you're looking for maintenance, that's going to be a KVO/TKO rate and that's anywhere from 20ml/hr to about 60 ml/hr. Put another way, about 1 mL/min. Match the drip rate so you get that rate... so if you have a 60 gtt/mL drip set, you run 60 gtt/min for a 60 mL/hr rate.
Field fluid rates are pretty much going to be either wide open or at that KVO/TKO rate. In-hospital or during interfacility transports, your infusion rate will be set by the physician and you'll go by that.
Field fluid rates are pretty much going to be either wide open or at that KVO/TKO rate. In-hospital or during interfacility transports, your infusion rate will be set by the physician and you'll go by that.
In what situation would you use tko?
In situations such as trauma and cardiogenic shock to a degree, you run wide open to get to 90 systolic/radial pulses, then titrate to maintain that bp. If doing a d10 drip, run practically wide open until BGL gets close to normal range, then titrate to maintain BGL. For dka and hhns, run practically wide open nonstop till they are at the er. For nausea and vomiting or simple dehydration, give 250-500ml boluses at a rate slightly more than tko, but not wide open. Somewhere in the middle, and reassess after each bolus for improvement in dehydration symptoms, or new problems arising. Does this sound pretty much correct? Anything to change or add?
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I have to ask: are you in school or working?
If in school, ask your Instructor.
If working, please stop.
If in school, ask your Instructor.
If working, please stop.
Here we go again… I’ve had enough of your negativity. I am in school, but sometimes it’s better to ask more people to get different opinions and compare them, rather than just asking one person. I would like to ask you to please stop responding to my posts if all you can do is be negative instead of helpful
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