Emergency Fluid & Electrolyte Therapy in Warm Climates

Table of Contents in Full

Inside cover – 1 Emergency Assessment & Intervention
Inside cover – 2 Climatic Data of the Intertropical Zone

  1. Acknowledgements

  2. Commonly Used Abbreviations And Symbols
    Abbreviations for Intravenous Solutions

  3. Introductive Note And General Principles
    How this Manual is organised
    How to use this Manual

  4. The Application of Disease States to Disturbances of Extracellular Fluid 

  5. Fluid & Electrolyte Imbalances
    1. Extracellular Fluid Volume Deficit
    specific Dosage & Rate Table for Initial Hydrating Solutions
    2. Extracellular Fluid Volume Excess
    3. Sodium Deficit of Extracellular Fluid
    4. Sodium Excess of Extracellular Fluid
    5. Potassium Deficit of Extracellular Fluid
    Specific therapeutic potassium replacement solutions
    Prophylactic potassium solutions
    Lactated prophylactic potassium solutions
    Potassium chloride concentrates for therapeutic potassium replacement
    6. Potassium Excess of Extracellular Fluid
    Solutions helpful in treatment of potassium excess
    7. Calcium Deficit of Extracellular Fluid
    Useful information about calcium
    Solutions helpful in treatment of calcium deficit
    8. Calcium Excess of Extracellular Fluid
    Solutions helpful in treatment of calcium excess
    9. Magnesium Deficit of Extracellular Fluid
    Useful information about magnesium
    Solutions helpful in treatment of magnesium deficit
    10. Primary Base Bicarbonate Deficit
    Solutions helpful in treatment of primary base bicarbonate deficit
    11. Primary Base Bicarbonate Excess
    Solutions helpful in treatment of primary base bicarbonate excess
    12. Carbonic Acid Deficit of Extracellular Fluid
    Solutions helpful in treatment of carbonic acid deficit
    13. Carbonic Acid Excess of Extracellular Fluid
    Solutions helpful in treatment of carbonic acid excess
    14. Plasma to Interstitial Fluid Shift
    Solutions helpful in treating shock
    Solutions helpful in treating burns
    Baxter – Parkland formula
    15. Interstitial Fluid to Plasma Shift
    Treatment of interstitial fluid to plasma shift
    16. Protein Deficit
    Treatment of protein deficit
    17. Calories Deficit
    Treatment of calories deficit

  6. Special Solutions
    Albumin, Serum – (5% and 25%)
    2.14 % Ammonium Chloride in Water
    M/6 Sodium r-Lactate Solution
    Lipid Emulsions for Total Parenteral Nutrition (TPN)
    Mannitol
    Protein i.v. nutrition
    Hydroxyethyl Starch (HES)
    Dextran
    THAM
    Oral Rehydration Solutions (ORS)
    Emergency home made Oral Rehydration Solution (ORS) - n° 1
    Emergency home made Oral Rehydration Solution (ORS) - n° 2
    Electrolyte Concentrations in commonly used Replacement Solutions
    Properties of main i.v. Solutions

  7. A Guide to Laboratory Test Values, Conversion Tables, Units of Measure
    Box 1: Electrolytes: Normal Values in the Serum
    Box 2: Normal Values (% of Body Weight) of Body Fluids
    Box 3: Use this simple Chart for Determining TBSA for Baby, Child or Adult
    Box 4: Conversion of mg/100 mL in mEq/L
    Box 5: Weight in “mg” of some ions and salts expressed in “mEq”
    Box 6: Conversion of Normal solution into a mol/L solution
    Box 7: Conversion of mg % mL in mEq/L
    Box 8: Amount of Substance : mole (mol)
    Box 9: Relative Atomic Mass and Valence
    Box 10: Relative Molecular Masses of Some Substances
    Box 11: The Essential Laboratory - Reference Values
    Box 12: Useful Data
    Box 13: Basic Metabolic Necessities in Relationship with the Age
    Box 14: Simple Measures of Capacity & Weight
    Box 15: Fluid Therapy in Children
    Box 16: Daily Caloric Requirements in Children
    Box 17: Daily Nutritional Requirements in Children
    Box 18: A Guide to Drugs for Cardiovascular Emergencies
    Box 19: Minerals
    Box 20: Drugs that Influence Laboratory Tests Values
    Box 21: Flow Rate Converters
    Daily Fluid Chart

  8. Miscellany Precautions, Suggestions and Useful Data
    Acidosis
    Acidosis, Respiratory
    Acidosis, Metabolic
    Additions of Carbohydrate
    Addition of Numerous Drugs
    Advantages and disadvantages of I.V. Medication
    Alkalosis
    Alkalosis, Respiratory
    Alkalosis, Metabolic
    Biologic Hazards
    Choice of a Vein
    Complications, I.V. related
    Haematoma
    Thrombosis
    Phlebitis
    Thrombophlebitis
    Infiltration
    Extravasation
    Local infection
    Septicaemia
    Venous spasm
    Circulatory overload
    Pulmonary oedema
    Air embolism
    Catheter embolism
    Erratic flow-rates
    Decompression Sickness, Treatment of Endocrine and Metabolic Emergencies
    Expiry Date
    Filters
    Fluid therapy: Precautions, Interactions, Compatibility & Incompatibility
    Infections, I.V. related -
    Epidemiology
    Prevention
    Nursing considerations
    Infusion phlebitis
    Septicaemia / Fungaemia
    Intravenous or Subcutaneous Administration
    Intravenous Therapy Risk
    Laboratory Tests to investigate Acid – base Disorders
    Techniques for measuring Na+ and K+ in serum or plasma
    Choice of technique and costs
    Malaria, Severe -
    Errors of fluid & electrolyte replacement
    Parenteral feeding
    Disadvantages
    Dextrose solutions for total Parenteral Nutrition
    Phlebitis (→ Infections, I.V. related -)
    Practice & Hazards of Electrolytic fluid Therapy
    Contra-indications
    Hazards
    Pregnancy & Gynaecologic Surgery, Special problems of
    Fluid & Electrolyte Balance in
    -Acute renal failure
    Extracellular fluid excess
    Severe pre-eclampsia
    Acidaemia
    Caesarean section
    Management of electrolyte abnormalities in gynaecologic surgery
    Renal failure, Acute -
    Specific Storage conditions
    Speed Shock
    Surgical Patient, Fluid Therapy in the -
    Pre-operative care
    Intra-operative care
    Post-operative care
    Vein Spasm
    Veterinary Medicine
    Health considerations & carrying capability
    Watering & feeding
    Dehydration
    Treatment
    War Surgery, Monitor and Manage Electrolyte & Fluid Therapy in-
    Early CH nutrition
    Pre- and post-operative fluid & electrolyte monitoring in hot climates
    Renal failure after extensive soft tissue injury
    Acute lung injury: the treatment of acidosis with THAM

  9. Useful Terms and Definitions
    Acclimatization in Adults and Children
    Acidifying Fluids
    Acidity
    Active Transport
    Albumin
    Aldosterone
    Alkalizing Fluids
    Amine
    Antidiuretic Hormone (ADH)
    Balanced Solutions
    Blood Substitutes
    Body fluids Content
    Intracellular fluid
    Extracellular fluid
    Interstitial fluid
    Intravascular fluid
    Body fluids Homeostasis
    Bolus
    Calcium
    Calorie
    Carbohydrates
    Carbohydrate in Water solution
    Chemical Incompatibility
    Colloid
    Colloid Infusion
    Colloids available for maintaining intravascular fluid volume
    Compatibility
    Crystalloid
    Crystalloid Infusion
    Dehydration
    Signs & Symptoms
    Treatment
    Dextran
    Indications
    Advantages
    Disadvantages
    Nursing considerations
    Dextrose 5% in Water
    Indications
    Advantages
    Disadvantages
    Nursing considerations
    Dextrose 20%, 50%, 70% in Water
    Drip System and Calculation of Drops/min to Administer
    Macro drip
    Micro drip
    Administering i. v. fluids
    Examples
    Drug Interaction
    Electrolyte
    Electrolytes in TPN
    Nursing considerations
    Electrolysis
    Epidemiology
    Equivalent WeightFat (Lipids)
    Fat emulsions
    Fructose
    Gauge
    Gelatine
    Glucose
    Heat
    Heat Cramps
    Symptoms & treatment
    Heat Oedema
    Symptoms & treatment
    Heat Exhaustion
    Symptoms & treatment
    Heat Stroke
    Symptoms & treatment
    Heat Syncope
    Symptoms & treatment
    Heat Tetany
    Symptoms & treatment
    Homeostasis
    Hydrating Fluids
    Hydrolysis
    Hyperglycaemia in Total Parenteral Nutrition
    Hyperkalaemia
    Hypernatraemia
    Hypertonic Fluids
    Hypokalaemia
    Hyponatraemia
    Hypotonic Fluids
    Insensible Loss
    Invert Sugar
    Ion
    Isotonic Fluids
    Ketone bodies (Ketosis)
    Lactate Fluids
    Indications
    Ringer’s injection
    Lactated Ringer’s injection
    Advantages
    Disadvantages
    Nursing considerations
    LD50
    Lipids (→ Fat)
    Magnesium sulphate
    Administration
    Interactions
    Contraindications
    Life-threatening side effects
    Guidelines for safely administration
    Mannitol
    Milliequivalent
    Mole, millimole
    Myoglobinuria
    Normal Saline solution
    Indications
    Advantages
    Disadvantages
    Nursing considerations
    Oncotic Pressure
    Osmolality
    Osmotic Pressure
    Over hydration
    Peptide
    PH
    Potassium
    Protein
    Pulmonary Homeostatic mechanism
    Sensible Loss
    Sodium bicarbonate (1.4%, 5%, 7.5%, 8.4%)
    Indications, Contraindications, Caution, Hazards
    Route
    Dosage
    Rate
    Sodium chloride solutions (0.45%, 0.9%, 3% to 5%)
    Solute
    Solutions (isotonic, hypotonic, hypertonic)
    Sorbitol and Xylitol
    Starch
    Sugars
    Relative sweetness of some sugars
    Sweating
    Trial, Clinical -
    Vesicant
    Water intoxication

  10. Appendix
    Biohazards & Disinfection Policy
    Overview of Common Disinfectants
    Overview of Common Antiseptic Compounds
    Approximate Comparative Costs of different I.V. Solutions
    Questions, Problems & Case
    Answers

  11. Sources of Additional Information and References