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