This document discusses fluid management and replacement during anesthesia. It describes how the body's fluid is divided into compartments and how dehydration can occur from fasting or fluid loss. It provides a formula to calculate a patient's fasting fluid deficit based on weight and time fasting. It also explains how to calculate fluid maintenance needs, insensible fluid loss, and additional fluids needed based on the level of surgical trauma. The goal is to replace all fluid losses to maintain adequate intravascular volume and prevent complications during and after surgery.
This document discusses the calculation of fluid requirements for children. It provides formulas for calculating daily and hourly maintenance fluid needs based on a child's weight. It also discusses calculating fluid needs using body surface area, especially for burn patients. The document outlines formulas for determining fluid replacement needs based on the percentage of dehydration. It provides examples of calculating fluid output and intravenous fluid drip rates. Calculating fluid plans is an important nursing intervention for managing dehydration in children.
Fluid management is a major part of hospital activity and peri-operative care. It is essential to understand fluid physiology and the compositions of different fluids prescribed in order to properly manage a patient's fluid balance. Regular assessment of the patient's clinical status is needed to determine fluid needs and ensure fluids are appropriately prescribed for resuscitation, maintenance, or replacement purposes.
This document discusses the initial management and assessment of major burns. It covers three key areas:
1) Assessment of burn area, which is important for calculating fluid resuscitation. The palm method, Wallace rule of nines, and Lund-Browder chart are described as methods to estimate burn percentage.
2) Fluid resuscitation regimens, with the Parkland formula being most commonly used. Goals are replacing fluid losses and maintaining urine output.
3) Evaluating burn depth and the need for escharotomies to relieve pressure in circumferential burns. Burn depth is difficult to determine and depends on factors like bleeding, sensation, and blanching response.
Fluid and electrolyte balance in a surgical patientImran Ansari
The document discusses fluid and electrolyte balance in surgical patients. It begins by explaining the concepts of extracellular and intracellular volume. It then recommends daily water intake of 2000-2500 ml to replace daily losses through urine, stool, and insensible losses. The document presents four case studies of different surgical patients and asks how pre-op, intra-op, and post-op fluid requirements would be managed in each case. Key factors discussed include maintenance fluids, replacing blood and third space losses during surgery, and giving low-sodium fluids without potassium in the immediate post-op period.
Fluid management aims to correct deficiencies, maintain circulating blood volume and adequate urine output. Total body water varies with age and gender, being distributed between intracellular, interstitial and extracellular fluid compartments. Intraoperative fluid requirements include maintenance, preoperative deficits, third spacing losses and blood replacement. Ringer's lactate is the ideal crystalloid choice. Close monitoring of vital signs and urine output is important to avoid fluid overload.
General Surgery ~~ Fluid management in AdultsYu-Hao Huang
Fluid management in adults involves balancing fluid intake and losses to maintain homeostasis. The body contains total body water (TBW) divided between intracellular fluid (ICF) and extracellular fluid (ECF). Water and electrolyte requirements are met through maintenance fluids which are administered based on weight. Additional fluids must be given to replace deficits from fasting, ongoing losses, blood loss, and third spacing during surgery. Fluid status is monitored for signs of hypo- or hypervolemia, and fluid therapy is adjusted based on the patient's condition and fluid balance. Proper fluid management is critical in the perioperative period to prevent organ hypoperfusion.
Intravenous Fluids In Surgical PatientsKIST Surgery
1) There are two main types of intravenous fluids used in surgical patients - crystalloids and colloids. Crystalloids contain electrolytes dissolved in water, while colloids contain larger soluble molecules that remain in the blood vessels.
2) The goals of fluid therapy are to maintain adequate intravascular volume based on the patient's fluid needs, deficits, and losses. Fluid requirements are calculated based on formulas accounting for maintenance needs and replacing ongoing losses.
3) Enhanced Recovery After Surgery (ERAS) protocols aim to optimize fluid management in the preoperative, intraoperative and postoperative periods by restricting unnecessary fluids to reduce complications like ileus.
This document discusses intravenous fluid therapy and transfusion therapy. It provides details on fluid compartments in the body, various intravenous fluid solutions including crystalloids, colloids, isotonic, hypotonic and hypertonic solutions. It describes how to assess fluid status and calculate fluid requirements during surgery. Complications of blood transfusion are outlined as well as components of blood that can be transfused. Vigilance is important when administering blood products due to risks of transfusion reactions and disease transmission.
This document discusses the calculation of fluid requirements for children. It provides formulas for calculating daily and hourly maintenance fluid needs based on a child's weight. It also discusses calculating fluid needs using body surface area, especially for burn patients. The document outlines formulas for determining fluid replacement needs based on the percentage of dehydration. It provides examples of calculating fluid output and intravenous fluid drip rates. Calculating fluid plans is an important nursing intervention for managing dehydration in children.
Fluid management is a major part of hospital activity and peri-operative care. It is essential to understand fluid physiology and the compositions of different fluids prescribed in order to properly manage a patient's fluid balance. Regular assessment of the patient's clinical status is needed to determine fluid needs and ensure fluids are appropriately prescribed for resuscitation, maintenance, or replacement purposes.
This document discusses the initial management and assessment of major burns. It covers three key areas:
1) Assessment of burn area, which is important for calculating fluid resuscitation. The palm method, Wallace rule of nines, and Lund-Browder chart are described as methods to estimate burn percentage.
2) Fluid resuscitation regimens, with the Parkland formula being most commonly used. Goals are replacing fluid losses and maintaining urine output.
3) Evaluating burn depth and the need for escharotomies to relieve pressure in circumferential burns. Burn depth is difficult to determine and depends on factors like bleeding, sensation, and blanching response.
Fluid and electrolyte balance in a surgical patientImran Ansari
The document discusses fluid and electrolyte balance in surgical patients. It begins by explaining the concepts of extracellular and intracellular volume. It then recommends daily water intake of 2000-2500 ml to replace daily losses through urine, stool, and insensible losses. The document presents four case studies of different surgical patients and asks how pre-op, intra-op, and post-op fluid requirements would be managed in each case. Key factors discussed include maintenance fluids, replacing blood and third space losses during surgery, and giving low-sodium fluids without potassium in the immediate post-op period.
Fluid management aims to correct deficiencies, maintain circulating blood volume and adequate urine output. Total body water varies with age and gender, being distributed between intracellular, interstitial and extracellular fluid compartments. Intraoperative fluid requirements include maintenance, preoperative deficits, third spacing losses and blood replacement. Ringer's lactate is the ideal crystalloid choice. Close monitoring of vital signs and urine output is important to avoid fluid overload.
General Surgery ~~ Fluid management in AdultsYu-Hao Huang
Fluid management in adults involves balancing fluid intake and losses to maintain homeostasis. The body contains total body water (TBW) divided between intracellular fluid (ICF) and extracellular fluid (ECF). Water and electrolyte requirements are met through maintenance fluids which are administered based on weight. Additional fluids must be given to replace deficits from fasting, ongoing losses, blood loss, and third spacing during surgery. Fluid status is monitored for signs of hypo- or hypervolemia, and fluid therapy is adjusted based on the patient's condition and fluid balance. Proper fluid management is critical in the perioperative period to prevent organ hypoperfusion.
Intravenous Fluids In Surgical PatientsKIST Surgery
1) There are two main types of intravenous fluids used in surgical patients - crystalloids and colloids. Crystalloids contain electrolytes dissolved in water, while colloids contain larger soluble molecules that remain in the blood vessels.
2) The goals of fluid therapy are to maintain adequate intravascular volume based on the patient's fluid needs, deficits, and losses. Fluid requirements are calculated based on formulas accounting for maintenance needs and replacing ongoing losses.
3) Enhanced Recovery After Surgery (ERAS) protocols aim to optimize fluid management in the preoperative, intraoperative and postoperative periods by restricting unnecessary fluids to reduce complications like ileus.
This document discusses intravenous fluid therapy and transfusion therapy. It provides details on fluid compartments in the body, various intravenous fluid solutions including crystalloids, colloids, isotonic, hypotonic and hypertonic solutions. It describes how to assess fluid status and calculate fluid requirements during surgery. Complications of blood transfusion are outlined as well as components of blood that can be transfused. Vigilance is important when administering blood products due to risks of transfusion reactions and disease transmission.
This document discusses fluid therapy in animals. It begins by describing the distribution of water in the body and the composition of intracellular and extracellular fluids. It then discusses three types of fluid disturbances: changes in volume, content, and distribution. The document outlines different types of fluid therapy including replacement, adjunctive, and supportive therapies. It provides details on routes of fluid administration and indications for intravenous fluids. Throughout, it discusses evaluating and monitoring fluid therapy, diagnosing and treating dehydration, and complications of intravenous fluids.
This document provides information and formulas for calculating dosages in various forms, including tablets, liquids, intravenous fluids and medications. It includes examples of calculating the number of tablets or amount of liquid needed based on the available dose, as well as formulas for determining intravenous drip rates in mL/hr or gtts/min based on the volume and time period. The document also addresses pediatric dosage calculations that factor the patient's weight.
This document provides information on fluid resuscitation in burn patients. It discusses the host response to burn injury, goals of resuscitation being prevention of shock and maintenance of tissue perfusion. Choice of resuscitation fluids include crystalloids and colloids. The Parkland formula is described for calculating fluid resuscitation needs in the first 24 hours. Monitoring of resuscitation includes urinary output, blood pressure, heart rate, hematocrit, and serum chemistries to assess adequacy of fluid resuscitation.
complete information about the fluid resuscitation in burn patients, types of care given to the patient in the hospital after burning accidents, fluid replacement therapy, medical management, nursing management.
This document discusses the composition and distribution of fluids in the human body. It notes that 60% of the body is fluid, with 40% being intracellular fluid and the remaining extracellular fluid distributed between interstitial fluid and intravascular fluid. It provides details on fluid requirements, losses, electrolyte concentrations in different compartments, and types of intravenous fluids including crystalloids and colloids. The document emphasizes the importance of fluid balance and maintenance of adequate hydration and outlines factors to consider for fluid management in pre-operative, intra-operative, and post-operative settings.
This document provides an overview of pediatric medication administration. Key points covered include:
- Converting between common units of measurement for medications
- Calculating safe medication dosages based on weight in kilograms
- Determining hourly IV fluid rates based on a child's weight
- Working through examples of calculating dosages and administration rates for specific pediatric medications
- The importance of ensuring medication dosages fall within established safe ranges
This document discusses fluid and electrolyte management in neonates. It outlines the physiological changes in neonates that impact fluid needs, including higher total body water and immature kidney function. It provides guidelines for calculating daily fluid requirements based on gestational age and weight. It describes the use of IV fluids for initial resuscitation and maintenance, adjusting for enteral feedings and weight changes. Conditions requiring IV fluids and formulas for replacing various fluid losses are also summarized.
This document discusses intravenous (IV) fluid therapy. It describes IV fluids as an effective way to administer large volumes of fluids and medications directly into the bloodstream. Common types of IV fluids include normal saline, Ringer's lactate, dextrose solutions, and blood products. The document outlines best practices for IV fluid administration and monitoring, including site preparation, flow rate calculation, dressing changes, and assessing for complications. The goal of IV therapy is to restore fluid and electrolyte balance and administer medications while preventing infections or other issues.
INTRAVENOUS FLUIDS AND COMPUTATION - NURSING FOUNDATIONMeegsEstabillo2
This document provides information on intravenous fluid therapy including:
- Types of IV solutions such as isotonic, hypotonic, and hypertonic solutions.
- Proper sites for venipuncture and tips for easier IV starts.
- Equipment used such as butterfly needles, saline locks, and IV administration sets.
- Calculating flow rates by determining mL/hr and drops/min based on the total volume and duration of infusion.
- Factors that can influence flow rates like arm position and tubing placement.
- Example practice questions are provided to demonstrate calculations.
This document provides information on intravenous fluid therapy including:
- Types of IV solutions such as isotonic, hypotonic, and hypertonic solutions.
- Proper sites for venipuncture and tips for easier IV starts.
- Equipment used such as butterfly needles, saline locks, and IV administration sets.
- Calculating flow rates by determining mL/hr and drops/min from the total volume and duration of infusion.
- Factors that can influence flow rates like arm position and tubing placement.
- Example practice questions are provided to demonstrate calculations.
Fluid management in the paediatric patient anaesthetist consideration...drriyas03
This document discusses fluid management in paediatric patients. It covers water physiology and fluid compartments in the body. Fluid volumes change with age from premature neonates to adults. Daily fluid losses are outlined. Methods for determining fluid requirements and correcting dehydration are presented. Intraoperative fluid replacement depends on the type and severity of surgery. Blood loss and transfusion thresholds are addressed. Selection of intravenous fluids must be tailored to the individual patient's needs.
The document discusses fluid and electrolyte therapy in pediatrics. It notes that children have higher fluid needs than adults due to greater insensible losses and immature kidneys. Total body water is a higher percentage in children compared to adults. Maintenance IV fluids replace electrolyte and water losses and provide calories. Fluid deficits due to dehydration are calculated as a percentage of body weight and restored with isotonic fluids like saline or Ringer's lactate. Ongoing losses are also measured and replaced to ensure intravascular volume is maintained.
1) The average adult requires around 2.4 liters of fluid per day to maintain electrolyte and water balance. Common IV fluids contain varying amounts of sodium, potassium, chloride, and other components.
2) Maintenance fluids are used to replace normal daily losses for patients who cannot take fluids orally, while resuscitation fluids in larger volumes are used to treat volume deficits or shock.
3) Choosing the right fluid, rate, and duration requires considering a patient's weight, renal function, electrolyte levels, and other clinical factors like underlying conditions that could impact fluid status.
Fluid management is essential for peri-operative patient care and impacts outcomes. Three key considerations for fluid prescription include the purpose of the fluid, the patient's weight and comorbidities, and laboratory values. Crystalloids are commonly used for volume resuscitation while colloids provide more sustained plasma expansion but risk allergic reactions. Proper fluid status assessment and strict input-output monitoring are important to avoid overhydration or dehydration.
This document discusses hematocrit, which is the fraction of blood volume comprised of formed elements like red blood cells. It is determined by centrifuging an anticoagulated blood sample in a calibrated tube. A higher hematocrit indicates increased blood viscosity and load on the heart, while a lower hematocrit may suggest anemia. Normal hematocrit ranges are 40-54% for males and 38-46% for females. Measuring hematocrit is an important screening tool for evaluating hematological conditions.
Dr. Alshehri's presentation covered intravenous fluids and acid-base balance for surgical patients. The key points discussed included:
1) Calculating daily fluid requirements using the 4-2-1 formula and understanding electrolyte needs.
2) Comparing different types of intravenous fluids including crystalloids like normal saline and lactated ringer's and colloids like albumin.
3) Identifying common fluid and electrolyte disturbances in surgical patients such as dehydration, hyponatremia, and hypokalemia and their treatment.
4) Explaining acid-base balance and different acid-base disorders like respiratory acidosis and metabolic alkalosis that can be analyzed on an
This document discusses fluid therapy in children. It describes the types of fluids used, including isotonic, hypotonic and hypertonic fluids. It outlines the clinical signs of dehydration from mild to severe. Laboratory tests for assessing dehydration including serum sodium, potassium and bicarbonate are also covered. The management of dehydration from mild to severe is outlined, including the use of oral rehydration solutions and intravenous fluids. Formulas for calculating fluid maintenance rates, water deficits and glucose requirements are provided.
1. Burn management involves rescuing and resuscitating the patient, then focusing on wound care, prevention of complications, and rehabilitation.
2. Key principles include airway management, fluid resuscitation, wound cleaning and coverage, nutrition, and physiotherapy.
3. Burn care proceeds through emergent, acute, and rehabilitation phases, with priorities like fluid resuscitation in the initial phase and wound closure in later phases.
1. Burn management involves rescuing the patient, resuscitating them with fluids, and referring them to a specialized burn unit. It proceeds through emergent, acute, and rehabilitation phases focused on wound care, preventing complications, and rehabilitation.
2. Initial priorities are airway management, fluid resuscitation based on burn severity formulas, wound assessment and care. Complications include electrolyte abnormalities that require monitoring and correction.
3. Burn patients require hospitalization based on American Burn Association guidelines considering factors like burn size, depth and inhalation injury. Intensive burn care focuses on intensive monitoring and wound management.
The document discusses acid-base balance and disorders. It defines acids and bases, and explains how the body maintains acid-base balance through buffers, respiratory regulation, and renal regulation. It describes the four major acid-base disorders: respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis. For each disorder it provides the primary cause, effects on bicarbonate and pH levels, and examples of compensatory mechanisms and potential treatments.
This document provides information on intraosseous vascular access. It discusses indications for IO insertion including cardiac arrest, deteriorating patient, trauma, and inability to obtain IV access. It reviews safe insertion of the EZ-IO needle including equipment, sites, and steps. Potential risks and complications are outlined. Drugs and fluids that can be administered via IO are noted. Practical tips are provided such as pushing fluids due to resistance. Patient safety tips emphasize obtaining definitive venous access when possible and removing the IO.
This document discusses fluid therapy in animals. It begins by describing the distribution of water in the body and the composition of intracellular and extracellular fluids. It then discusses three types of fluid disturbances: changes in volume, content, and distribution. The document outlines different types of fluid therapy including replacement, adjunctive, and supportive therapies. It provides details on routes of fluid administration and indications for intravenous fluids. Throughout, it discusses evaluating and monitoring fluid therapy, diagnosing and treating dehydration, and complications of intravenous fluids.
This document provides information and formulas for calculating dosages in various forms, including tablets, liquids, intravenous fluids and medications. It includes examples of calculating the number of tablets or amount of liquid needed based on the available dose, as well as formulas for determining intravenous drip rates in mL/hr or gtts/min based on the volume and time period. The document also addresses pediatric dosage calculations that factor the patient's weight.
This document provides information on fluid resuscitation in burn patients. It discusses the host response to burn injury, goals of resuscitation being prevention of shock and maintenance of tissue perfusion. Choice of resuscitation fluids include crystalloids and colloids. The Parkland formula is described for calculating fluid resuscitation needs in the first 24 hours. Monitoring of resuscitation includes urinary output, blood pressure, heart rate, hematocrit, and serum chemistries to assess adequacy of fluid resuscitation.
complete information about the fluid resuscitation in burn patients, types of care given to the patient in the hospital after burning accidents, fluid replacement therapy, medical management, nursing management.
This document discusses the composition and distribution of fluids in the human body. It notes that 60% of the body is fluid, with 40% being intracellular fluid and the remaining extracellular fluid distributed between interstitial fluid and intravascular fluid. It provides details on fluid requirements, losses, electrolyte concentrations in different compartments, and types of intravenous fluids including crystalloids and colloids. The document emphasizes the importance of fluid balance and maintenance of adequate hydration and outlines factors to consider for fluid management in pre-operative, intra-operative, and post-operative settings.
This document provides an overview of pediatric medication administration. Key points covered include:
- Converting between common units of measurement for medications
- Calculating safe medication dosages based on weight in kilograms
- Determining hourly IV fluid rates based on a child's weight
- Working through examples of calculating dosages and administration rates for specific pediatric medications
- The importance of ensuring medication dosages fall within established safe ranges
This document discusses fluid and electrolyte management in neonates. It outlines the physiological changes in neonates that impact fluid needs, including higher total body water and immature kidney function. It provides guidelines for calculating daily fluid requirements based on gestational age and weight. It describes the use of IV fluids for initial resuscitation and maintenance, adjusting for enteral feedings and weight changes. Conditions requiring IV fluids and formulas for replacing various fluid losses are also summarized.
This document discusses intravenous (IV) fluid therapy. It describes IV fluids as an effective way to administer large volumes of fluids and medications directly into the bloodstream. Common types of IV fluids include normal saline, Ringer's lactate, dextrose solutions, and blood products. The document outlines best practices for IV fluid administration and monitoring, including site preparation, flow rate calculation, dressing changes, and assessing for complications. The goal of IV therapy is to restore fluid and electrolyte balance and administer medications while preventing infections or other issues.
INTRAVENOUS FLUIDS AND COMPUTATION - NURSING FOUNDATIONMeegsEstabillo2
This document provides information on intravenous fluid therapy including:
- Types of IV solutions such as isotonic, hypotonic, and hypertonic solutions.
- Proper sites for venipuncture and tips for easier IV starts.
- Equipment used such as butterfly needles, saline locks, and IV administration sets.
- Calculating flow rates by determining mL/hr and drops/min based on the total volume and duration of infusion.
- Factors that can influence flow rates like arm position and tubing placement.
- Example practice questions are provided to demonstrate calculations.
This document provides information on intravenous fluid therapy including:
- Types of IV solutions such as isotonic, hypotonic, and hypertonic solutions.
- Proper sites for venipuncture and tips for easier IV starts.
- Equipment used such as butterfly needles, saline locks, and IV administration sets.
- Calculating flow rates by determining mL/hr and drops/min from the total volume and duration of infusion.
- Factors that can influence flow rates like arm position and tubing placement.
- Example practice questions are provided to demonstrate calculations.
Fluid management in the paediatric patient anaesthetist consideration...drriyas03
This document discusses fluid management in paediatric patients. It covers water physiology and fluid compartments in the body. Fluid volumes change with age from premature neonates to adults. Daily fluid losses are outlined. Methods for determining fluid requirements and correcting dehydration are presented. Intraoperative fluid replacement depends on the type and severity of surgery. Blood loss and transfusion thresholds are addressed. Selection of intravenous fluids must be tailored to the individual patient's needs.
The document discusses fluid and electrolyte therapy in pediatrics. It notes that children have higher fluid needs than adults due to greater insensible losses and immature kidneys. Total body water is a higher percentage in children compared to adults. Maintenance IV fluids replace electrolyte and water losses and provide calories. Fluid deficits due to dehydration are calculated as a percentage of body weight and restored with isotonic fluids like saline or Ringer's lactate. Ongoing losses are also measured and replaced to ensure intravascular volume is maintained.
1) The average adult requires around 2.4 liters of fluid per day to maintain electrolyte and water balance. Common IV fluids contain varying amounts of sodium, potassium, chloride, and other components.
2) Maintenance fluids are used to replace normal daily losses for patients who cannot take fluids orally, while resuscitation fluids in larger volumes are used to treat volume deficits or shock.
3) Choosing the right fluid, rate, and duration requires considering a patient's weight, renal function, electrolyte levels, and other clinical factors like underlying conditions that could impact fluid status.
Fluid management is essential for peri-operative patient care and impacts outcomes. Three key considerations for fluid prescription include the purpose of the fluid, the patient's weight and comorbidities, and laboratory values. Crystalloids are commonly used for volume resuscitation while colloids provide more sustained plasma expansion but risk allergic reactions. Proper fluid status assessment and strict input-output monitoring are important to avoid overhydration or dehydration.
This document discusses hematocrit, which is the fraction of blood volume comprised of formed elements like red blood cells. It is determined by centrifuging an anticoagulated blood sample in a calibrated tube. A higher hematocrit indicates increased blood viscosity and load on the heart, while a lower hematocrit may suggest anemia. Normal hematocrit ranges are 40-54% for males and 38-46% for females. Measuring hematocrit is an important screening tool for evaluating hematological conditions.
Dr. Alshehri's presentation covered intravenous fluids and acid-base balance for surgical patients. The key points discussed included:
1) Calculating daily fluid requirements using the 4-2-1 formula and understanding electrolyte needs.
2) Comparing different types of intravenous fluids including crystalloids like normal saline and lactated ringer's and colloids like albumin.
3) Identifying common fluid and electrolyte disturbances in surgical patients such as dehydration, hyponatremia, and hypokalemia and their treatment.
4) Explaining acid-base balance and different acid-base disorders like respiratory acidosis and metabolic alkalosis that can be analyzed on an
This document discusses fluid therapy in children. It describes the types of fluids used, including isotonic, hypotonic and hypertonic fluids. It outlines the clinical signs of dehydration from mild to severe. Laboratory tests for assessing dehydration including serum sodium, potassium and bicarbonate are also covered. The management of dehydration from mild to severe is outlined, including the use of oral rehydration solutions and intravenous fluids. Formulas for calculating fluid maintenance rates, water deficits and glucose requirements are provided.
1. Burn management involves rescuing and resuscitating the patient, then focusing on wound care, prevention of complications, and rehabilitation.
2. Key principles include airway management, fluid resuscitation, wound cleaning and coverage, nutrition, and physiotherapy.
3. Burn care proceeds through emergent, acute, and rehabilitation phases, with priorities like fluid resuscitation in the initial phase and wound closure in later phases.
1. Burn management involves rescuing the patient, resuscitating them with fluids, and referring them to a specialized burn unit. It proceeds through emergent, acute, and rehabilitation phases focused on wound care, preventing complications, and rehabilitation.
2. Initial priorities are airway management, fluid resuscitation based on burn severity formulas, wound assessment and care. Complications include electrolyte abnormalities that require monitoring and correction.
3. Burn patients require hospitalization based on American Burn Association guidelines considering factors like burn size, depth and inhalation injury. Intensive burn care focuses on intensive monitoring and wound management.
The document discusses acid-base balance and disorders. It defines acids and bases, and explains how the body maintains acid-base balance through buffers, respiratory regulation, and renal regulation. It describes the four major acid-base disorders: respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis. For each disorder it provides the primary cause, effects on bicarbonate and pH levels, and examples of compensatory mechanisms and potential treatments.
This document provides information on intraosseous vascular access. It discusses indications for IO insertion including cardiac arrest, deteriorating patient, trauma, and inability to obtain IV access. It reviews safe insertion of the EZ-IO needle including equipment, sites, and steps. Potential risks and complications are outlined. Drugs and fluids that can be administered via IO are noted. Practical tips are provided such as pushing fluids due to resistance. Patient safety tips emphasize obtaining definitive venous access when possible and removing the IO.
This document discusses the cardiovascular, respiratory, renal, hepatic, and other physiologic effects of pneumoperitoneum during laparoscopic surgery. Pneumoperitoneum, or insufflation of carbon dioxide gas into the abdominal cavity, can cause hemodynamic changes such as decreased venous return and cardiac output. It can also decrease lung volumes and impair respiratory function. These effects are more pronounced in elderly or debilitated patients undergoing laparoscopic surgery. The document emphasizes the importance of intraoperative monitoring and management strategies to optimize patient hemodynamics and ventilation during pneumoperitoneum, especially in high-risk patients.
Physiologic changes during pregnancy.pptxTadesseFenta1
Physiological changes during pregnancy alter the body's response to anesthesia. These changes begin early in pregnancy and progress significantly. By term, there are reductions in MAC values (up to 40%), sensitivity to local anesthetics (up to 30%), and FRC (up to 20%). Pregnant women also experience increased oxygen consumption (20-50%), minute ventilation (40-50%), cardiac output (up to 50%), blood volume (45%), and risk of aspiration. Anesthesia requires accounting for these changes through techniques like left uterine displacement, preoxygenation, and rapid sequence induction.
This document discusses medical ethics and key concepts. It defines ethics as a system of moral principles that affect decision making. Medical ethics applies these principles to medicine and considers patients' rights and welfare. The four basic principles of medical ethics are respect for autonomy, non-maleficence, beneficence, and justice. Effective communication is important for maintaining ethics and professionalism in healthcare. Anesthesiologists must thoughtfully communicate with patients throughout the perioperative process to respect patient autonomy and fulfill their professional duties.
Anesthetic Management of Abdominal Surgery.pptxTadesseFenta1
This document outlines an anesthesia course for abdominal and genitourinary surgery. The course aims to enable anesthetists to safely manage anesthesia for patients undergoing abdominal, gastrointestinal, hepatobiliary, anal, and genitourinary surgeries. It covers preoperative evaluation, risks associated with abdominal surgery, anesthetic techniques for different procedures, postoperative complications, and management of patients with hepatic or cardiovascular disease. The course assessments include assignments, quizzes, and a final written exam.
Anesthesia for Genitourinary Surgery.pptxTadesseFenta1
This document provides information about anesthesia for genitourinary surgeries and procedures. It discusses considerations for cystoscopy, transurethral resection of the prostate (TURP), lithotripsy, and the lithotomy position. Regional or general anesthesia is typically used depending on the procedure and patient factors. Complications of TURP can include hemorrhage, TURP syndrome from fluid absorption, bladder perforation, hypothermia, septicemia, and disseminated intravascular coagulation. Careful monitoring is important to detect issues like fluid overload and hyponatremia.
This document outlines an EMT training course on advanced airway management and the use of the pharyngeal esophageal airway device (PEAD), also known as the Combitube. The agenda covers respiratory anatomy and physiology, respiratory volumes and management, assessing respiratory problems, respiratory/cardiac arrest management, basic airway techniques, suctioning, and the use of dual-lumen airway devices like the Combitube. Objectives are provided for each lesson, which include demonstrating techniques like Combitube insertion and ensuring correct placement. Practical skills testing with a physician is also mentioned.
This document provides an overview of respiratory physiology, including:
- The structures and functions of the respiratory system
- The mechanics of breathing involving the lungs, chest wall, diaphragm and pleura
- The respiratory center in the brainstem that controls breathing
- Gas exchange that occurs between the alveoli and blood in the lungs
- Factors that impact ventilation and perfusion matching in the lungs
- Definitions of various lung volumes and capacities measured in respiratory physiology
The document discusses regional anesthesia techniques including central nerve blocks like spinal, epidural, and caudal anesthesia as well as peripheral nerve blocks. It provides detailed anatomy of the spinal column and spinal cord. It describes the techniques for performing spinal and epidural anesthesia including patient positioning, skin preparation, needle placement, and assessment of the block. Factors affecting the spread and level of the block are also discussed.
This document discusses thoracic anesthesia and includes outlines of topics, objectives, and details on preoperative evaluation, preparation, intraoperative monitoring, physiology of the lateral decubitus position under different conditions, and management of one-lung ventilation. Specifically, it covers assessing the surgical patient, optimizing medical conditions preoperatively, important intraoperative monitors, how induction of anesthesia and opening the chest impact ventilation and perfusion in the lateral position, and goals of managing one-lung ventilation.
Anesthesia for Patients with Renal Disease.pptxTadesseFenta1
The document discusses anesthesia considerations for patients with renal disease undergoing various genitourinary surgeries. It covers the effects of anesthetic agents on renal function, as well as positioning techniques and their physiologic impacts. Guidelines are provided for preoperative evaluation, induction, maintenance, fluid management, and specific procedures like TURP to safely anesthetize patients with renal impairment.
The document discusses common renal pathologies and their management in the perioperative period. It covers acute renal failure (ARF), chronic renal failure (CRF), diabetic nephropathy, nephrotic syndrome, glomerulonephritis, and pyelonephritis. ARF is classified as prerenal, intrinsic, or postrenal based on etiology. CRF results in fluid and electrolyte abnormalities, cardiac and pulmonary issues, and anemia. Diabetic nephropathy is caused by hypertension and hyperglycemia damaging the kidneys over time. Treatment focuses on controlling blood sugar and hypertension.
This document discusses the pathophysiology and management of burn patients. It covers:
1) Major burns cause massive tissue destruction and inflammatory response, leading to burn shock from fluid shifts and systemic effects if >20% TBSA.
2) Burns trigger a hypermetabolic response for weeks, with increased cardiac work and protein catabolism impairing healing.
3) Resuscitation follows the Parkland formula to replace fluid losses. Fluid management aims to maintain urine output and prevent organ dysfunction.
The document discusses airway anatomy and equipment for airway management. It reviews the anatomy of the upper airway from the nose to the bronchi and describes key differences in pediatric anatomy. Common airway equipment is outlined including laryngoscopes, endotracheal tubes, face masks, and laryngeal mask airways. Effective face mask ventilation techniques are also summarized.
The operating room poses hazards including physical (back injury, fire), chemical (anesthetic gases, cleaning agents), and biological (infectious materials, needle sticks) risks. Regulations and guidelines aim to minimize these dangers. Grounding systems prevent electric shocks to patients, while fire risks are reduced by separating fuels, heat sources, and oxygen. Catastrophic events like anaphylaxis and malignant hyperthermia require immediate interventions - anaphylaxis treatment includes epinephrine, while malignant hyperthermia involves dantrolene, cooling, and oxygen administration. The resuscitation trolley must contain appropriate drugs to manage emergencies.
The document provides information on instrument processing, including the steps involved in decontamination, cleaning, sterilization, and high-level disinfection. It describes the learning objectives, introduces key terms, and discusses various chemical disinfectants and their appropriate uses. Specific processes and best practices are outlined for decontamination using chlorine solutions, cleaning instruments, sterilization using various methods like steam, dry heat and chemicals, and high-level disinfection through boiling, steaming or chemicals. Factors that impact effectiveness and proper techniques, concentrations, exposure times are emphasized throughout.
The document provides guidelines for infection prevention and control in operating theatres. It discusses principles like considering all people potentially infectious, hand hygiene, use of personal protective equipment (PPE) like gloves, gowns and masks. It describes different types of PPE and when they should be used. Surgical scrubs and maintaining asepsis are also outlined, including inspecting hands for cuts, removing jewelry, adjusting masks and scrubs lasting 5 minutes with specific techniques. Strict personal hygiene is necessary for operating room workers to prevent transmission of infections.
The document outlines the organization and personnel roles in the operating room (OR). It discusses the physical areas of the OR including design, equipment, and traffic flow. It describes the roles of the sterile team including the surgeon, assistants, and scrub nurse who maintain the sterile field. The roles of the unsterile team including the anesthesia provider and circulating nurse who prepare supplies and equipment are also outlined. Specific responsibilities for each role in pre-operative, intra-operative, and post-operative periods are provided. Item counts are performed before and after procedures for patient and personnel safety.
Perioperative Pain Management by abe 2018.pptTadesseFenta1
The document discusses acute and chronic pain management. It covers definitions of pain, physiology of pain including pathways and modulation, assessment of pain, classification of pain as acute or chronic and nociceptive or neuropathic. It also discusses importance of treating acute perioperative pain to reduce complications and enhance recovery while balancing risks of adverse effects from overtreatment of pain. Management of both acute and chronic pain is an important objective of the course.
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Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
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Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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2. Course Objectives
BY THE END OF THE COURSE THE STUDENTS WILL BE ABLE
TO:
DESCRIBE THE BODY FLUID COMPOSITION AND
COMPARTMENTS
DIAGNOSE FLUID, ELECTROLYTE, AND ACID-BASE
ABNORMALITIES,
EXPLAIN THE PRINCIPLES OF FLUID THERAPY
MANAGE FLUID, ELECTROLYTE, AND ACID-BASE
ABNORMALITIES
4. Fluid Management and
Replacement
Water makes up a large portion of the human body.
It is vital to its function.
55% of the average man’s body weight is water.
45% of a woman’s body weight is water.
80% of an infant’s bodyweight is water
5. c
Bodily fluid can be divided into extracellular and intracellular.
Extracellular fluid consists of
intravascular fluid and interstitial fluid.
Intravascular fluid includes blood and plasma. Interstitial fluid is located
between cells.
Intracellular fluid is located within the cell.
The adult male’s weight, by fluid compartment, is shown below.
6. Cont.
Division of Adult Fluid Compartment Based on Body Weight
40% of body weight Intracellular Fluid
15% of body weight Interstitial Fluid
5% of body weight Blood Plasma
7. c
A hot tropical environment and/or dry environment, combined with
fasting prior to surgery, requires careful planning and replacement of
the patient’s fluid deficit. A fasting patient becomes dehydrated.
The goal of replacing fluids is to restore the patient’s intravascular
volume.
This will help prevent tachycardia and/or hypotension during
anesthesia.
Hydration improves the body’s ability to carry oxygen and lowers the
incidence of nausea and vomiting in the postoperative period.
8. Preoperative Evaluation
The patient should be evaluated for dehydration. The amount of time the
patient has fasted should be determined.
If the patient is experiencing acute and excessive nausea, vomiting, or diarrhea,
it is not unreasonable to delay an elective surgical procedure and correct the
patient’s severe dehydration.
The patient’s fluids may be replaced with oral rehydration solution (ORS) or
intravenous fluids.
ORS is not effective for patients who have an ileus or bowel obstruction.
The signs and symptoms of dehydration may include the following
9. Signs & Symptoms of
Dehydration
Dry tongue
Sunken eyes
Loss of skin turgor
Cool and cyanotic extremities
Absence of veins by sight
Hypotension (low blood pressure)
Tachycardia (fast heart rate)
Low urine output
High specific gravity on urinalysis
Sunken fontanel on infants
10. Calculating Fasting Fluid Deficit
It is important to determine the length of time your patient has been fasting.
The patient should be weighed on the day of surgery. This is the first step in
determining how much fluid to administer to the patient.
The 4-2-1 formula is used to calculate the patient’s fasting fluid deficit.
The 4-2-1formula is used for all age groups.
The 1st 10 kg of the patient’s weight is multiplied by 4ml per kg.
The 2nd 10 kg of the patient’s weight is multiplied by 2ml per kg.
The remaining weight in kg is multiplied by 1 ml per kg.
The total number of ml’s are multiplied by the number of hours the patient has
been fasting.
11. c
4 ml per kg per hour for 1-10 kg
2 ml per kg per hour for 11-20 kg
1 ml per kg per hour for 21 kg and up
12. c
Example: Calculate the fasting fluid deficit for a patient who weighs 60 kg. The
patient has fasted for 8 hours.
The first 10 kg is multiplied by 4 ml and equals 40 ml. For kg 11-20, multiply 10
kg by 2 ml per kg. This equals 20 ml.
The remaining 40 kg is multiplied by 1 ml and equals 40 ml. 40 + 20 + 40 = 100
ml. Multiply 100 ml by the number of hours that the patient has fasted.
100 X 8 equals 800 ml.
13. c
Example: Calculate the fasting fluid deficit for an 8 kg child.
The child has fasted for 8 hours. 8 kg multiplied by 4 ml would equal 32
ml.
32 ml multiplied by 8 hours would equal 256ml.
14. c
The fasting fluid deficit is generally administered over 3 hours. One half of the
deficit is infused during the first hour.
The 2nd half is administered over 2 hours.
In the first example, approximately 400 ml would be infused during the first hour.
200 ml would be infused during the second hour.
200 ml would be infused during the third hour.
In the second example, 128 ml would be administered during the first hour.
64 ml would be administered during the second hour.
64 ml would be infused during the third hour.
Prior to induction of anesthesia an IV should be started and rehydration initiated.
Pediatric patients receiving an inhaled anesthetic induction are an exception to this
rule.
15. Intraoperative Fluid Requirements
Fluid Maintenance Requirements
Patients require fluid maintenance during surgery and in the immediate
postoperative period
The patient should receive IV fluid maintenance replacement until they
are able to take oral fluids.
The amount of IV fluid the patient requires for maintenance is
calculated by the 4-2-1 formula..
17. c
The first 10 kg is multiplied by 4 ml and equals 40 ml. For kg
11-20, multiply 10 kg by 2 ml per kg. This equals 20 ml.
The remaining 40 kg is multiplied by 1 ml and equals 40 ml. 40 + 20 +
40 = 100 ml.
The patient should receive 100 ml per hour in maintenance fluid.
Example: The fluid maintenance requirements for an 8 kg child would
be calculated as follows.
8 kg multiplied by 4 ml would equal 32 ml.
The patient should receive 32 ml per hour in maintenance fluid.
18. Insensible Fluid Loss
Patients experience insensible fluid loss during surgery. This fluid is lost by
evaporation from the respiratory tract, sweating, and elimination.
Insensible fluid loss is calculated by multiplying 2 ml per kg per hour of surgery.
Fluid Management and Replacement Fluids
Insensible Loss replace at 2 ml/kg/hour
19. c
Example: Insensible fluid loss for a patient whose weight is 60 kg would be
calculated as follows.
60 x 2 would equal 120 ml.
This is the amount of fluid that would be replaced during each hour of surgery.
Example: Insensible fluid loss for a patient whose weight is 8 kg would be as
follows.
8 x 2 = 16 ml.
This is the amount of fluid that should be replaced for insensible fluid loss during
surgery.
20. Fluid Replacement Based on Surgical
Trauma
The extent of surgical trauma influences the amount of fluid that the patient will
require during surgery.
IV replacement of fluid is based on the amount of tissue exposed, evaporation, and
movement of fluids during surgery (3rd spacing).
Minor surgical procedures do not result in major tissue trauma, fluid shifts, or fluid
loss. The amount is minimal. Moderate to severe surgical procedures result in a
greater degree of tissue trauma, fluid shifts, and fluid loss.
An example of a minor surgical procedure would be a procedure on the eye.
An example of a surgical procedure involving severe surgical trauma would be an
intra-abdominal procedure
21. Minimal Trauma 3-4 ml/kg/hour
Moderate Trauma 5-6 ml/kg/hour
Severe Trauma 7-8 ml/kg/hour
Example: The amount of fluid required to replace losses in a patient weighing 60
kg, undergoing a minimally traumatic surgical procedure would be as follows.
60 kg multiplied by 3 ml would equal 180 ml per hour.
Example: The amount of fluid required to replace losses in a patient weighing 8
kg, undergoing a minimally traumatic surgical procedure, would be as follows. 8
kg multiplied by 3 ml would equal 24 ml per hour.
22. Blood Loss
Blood loss is replaced with 3 ml of IV solution for every 1 ml of blood
loss.
Surgical procedures that result in minimal blood loss are not generally a
big concern.
Surgical cases resulting in larger blood losses should be carefully
monitored.
It is important to estimate how much blood has been lost and replace
it.
23. IV Solutions
Practice setting may dictate the type of intravenous fluid that is
available to the anesthesia provider.
Each intravenous solution contains different components.
Below is a table that compares the patient’s extra cellular fluid (ECF)
composition with the components found in common IV solutions.
24. c
Lactated ringers or normal saline are preferred for fluid replacement
during anesthesia and surgery.
Lactated ringers are generally administered to an adult.
Normal saline is generally administered to pediatric patients.
Dextrose containing solutions should not be routinely used
25. Putting It All Together
Determine the patient’s weight in kg.
Determine the number of hours that the patient has fasted.
Calculate the patients IV fluid requirements.
First, calculate the patient’s fasting fluid deficit.
Second, calculate the patient’s fluid maintenance requirement.
The fluid maintenance requirement is the amount of fluid
administered during each hour of surgery.
Fluid maintenance requirements should continued postoperatively until
the patient is taking oral fluids.
26. c
Third, calculate the patient’s insensible fluid loss.
Fourth, calculate the patient’s fluid requirements based on the degree
of surgical trauma.
Calculating the patient’s fluid requirements may seem complicated at
first.
With practice it will become easy and natural. Ideally, the calculations
should be completed prior to surgery.
It is helpful to write the calculations out.
27. c
Fasting Fluid Deficit 4 ml per kg per hour for 1-10 kg
2 ml per kg per hour for 11-20 kg
1 ml per kg per hour for 21 kg on up
Maintenance Fluids 4 ml per kg per hour for 1-10 kg
2 ml per kg per hour for 11-20 kg
1 ml per kg per hour for 21 kg on up
Insensible Fluid Loss 2 ml per kg per hour
Fluid Management and Replacement
Fluids
Fluid Requirements minimal trauma = 3-4 ml per kg per hour
Based on Surgical moderate trauma= 5-6 ml per kg per hour
Trauma severe trauma = 7-8 ml per kg per hour
28. c
Example: Calculate the fasting fluid deficit for a patient who weighs 60 kg.
The patient has fasted for 8 hours.
The first 10 kg is multiplied by 4 ml and equals 40 ml.
For kg 11-20, multiply 10 kg by 2 ml. This equals 20 ml.
The last 40 kg is multiplied by 1 ml and equals 40 ml. 20 + 40 + 40 = 100
ml.
Multiply 100 ml by 8 hours. The fasting fluid deficit is 800 ml.
Give ½ this amount the first hour, followed by ¼ the second hour, and ¼
the third hour.
Calculate the maintenance fluid replacement.
29. c
The first 10 kg is multiplied by 4 ml and equals 40 ml. For kg 11-20,
multiply 10 kg by 2 ml. This equals 20 ml. The last 40 kg is multiplied by
1 ml and equals 40 ml. 40 + 20 + 40 = 100 ml.
The patient should receive 100 ml per hour in maintenance fluid.
This is the amount of fluid that the patient should continue to receive
until they are able to take oral fluids.
Calculate the insensible fluid loss by multiplying 2 ml by each kg of
weight.
60 kg multiplied by 2 ml equals 120 ml.
30. c
This is the amount of fluid to administer during each hour of surgery.
Calculate the surgical trauma fluid loss (minor) by multiplying 3 ml by
each kg of weight. 60 kg multiplied by 3 ml equals 180 ml.
This is the amount of fluid that should be administered during each
hour of the surgical procedure.
31. summery
Fasting fluid deficit = 800 ml (400 ml 1st hour, 200 ml 2nd hour, 200 ml
3rd hour, 0 ml for the 4th hour, etc.)
Maintenance fluid = 100 ml per hour
Insensible loss = 120 ml per hour
Surgical Trauma fluid loss (minor) = 180 ml/hr
32. c
During the first hour the patient would receive 800 ml (400 + 100 + 120
+ 180 = 800 ml);
during the second hour of surgery the patient would receive 600 ml
(200 + 100 + 120 + 180 = 600 ml);
during the third hour of surgery the patient would receive 600 ml (200 +
100 + 120 + 180 = 600 ml)
. During the fourth hour of surgery the patient would receive the
amount of fluid calculated for maintenance fluid requirements,
insensible loss, and surgical trauma.
33. c
Fluid replacement would not include the fasting fluid deficit.
This deficit has already been replaced in the preceding three hours.
Blood loss is replaced with 3 ml of IV fluid for every 1 ml of blood loss.
Replacement occurs as blood is lost during the surgical procedure
34. c
Example: Calculate the fasting fluid deficit for a patient who weighs 8 kg.
The patient has fasted for 8 hours.
8 kg is multiplied by 4 ml and equals 32 ml. 32 ml multiplied by 8 hours
equals 256 ml.
This is your fasting fluid deficit. Give ½ this amount the first hour, followed
by ¼ the second
hour, and ¼ the third hour.
Calculate the maintenance fluid replacement. 8 kg is multiplied by 4 ml
and equals 32 ml.
The patient should receive 32 ml per hour in maintenance fluid
replacement.
35. c
Calculate the insensible fluid loss by multiplying 2 ml by each kg of
body weight.
8 kg multiplied by 2 ml equals 16 ml.
This is the amount of fluid to administer during each hour of surgery.
Calculate the surgical trauma fluid loss (minor) by multiplying 3 ml by
each kg of weight.
8 kg multiplied by 3 ml equals 24 ml.
This is the amount of fluid that should be administered each hour of
the surgical procedure
36. c
Fasting fluid deficit = 256 ml (128 ml 1st hour, 64 ml 2nd hour, 64 ml
3rd hour, 0 ml for the 4thhour, etc.)
Maintenance fluid = 32 ml per hour
Insensible loss = 16 ml per hour
Surgical Trauma fluid loss (minor) = 24 ml/hr
37. c
During the first hour of surgery the patient would receive 200 ml of fluid (128 + 32 +
16 + 24 = 200 ml);
during the second hour of surgery the patient would receive 136 ml (64 + 32 + 16 +
24 = 136 ml);
during the third hour of surgery the patient would receive 136 ml
(64 + 32 + 16 + 24 = 136 ml).
During the fourth hour of surgery the patient would receive the amount of fluid
calculated for maintenance fluid requirements, insensible loss, and surgical trauma.
Fluid replacement would not include the fasting fluid deficit replacement.
This has already been replaced in the preceding 3 hours.
Blood loss is replaced with 3 ml of IV fluid for every 1 ml of blood loss
. Replacement occurs as blood is lost during the procedure. Administer 3 ml of IV
solution for every 1 ml of blood loss.
38. NB.
Drawing a simple grid can help keep track of fluid replacement.
1st Hour 2nd Hour 3rd Hour 4th Hour
Fluid Deficit
Maintenance Fluid
Surgical Trauma
Blood Loss
Total
39. Estimating Blood Volume
Patients undergoing a surgical procedure that may result in significant
blood loss should have an estimated blood volume calculated.
This is calculated with the patient’s preoperative weight and
preoperative hematocrit.
The table below is the approximate blood volume based on age and
weight.
40. c
Age ml/kg of weight
Premature Infant 100-120 ml/kg
Full Term Infant 90 ml/kg
Infants 3-12 months 80 ml/kg
1 year old to Adult 70 ml/kg
41. c
To estimate the maximal allowable blood loss the anesthesia provider
should have an idea, based on the patient’s physical condition, at what
level of hematocrit blood replacement should occur.
A general rule is that at a blood loss greater than 25-30% of the
patient’s estimated blood volume a transfusion may become necessary.
It may be less than this if the patient has significant disease processes
such as cardiovascular disease.
The ability to transfuse blood depends upon the capabilities of
individual practice settings.
42. c
To calculate the maximal allowable blood loss, first estimate the
patient’s blood volume
. Example, a 65 kg adult would have an estimated blood volume of 70
ml per kg. 65 multiplied by 70 equals 4,550 ml of estimated blood.
Next, the preoperative hematocrit should be known. In this example it
was 36%. Since the patient is healthy, the
anesthesia provider has decided to allow the hematocrit to decline to a
level of 25%.
The formula for calculating the maximal estimated blood loss is as
follows:
43. EBV calculated
Surgeons and anesthesia providers usually underestimate blood loss.
It is important to monitor the suction bottles, sponges, drapes, gowns,
and the floor for blood loss.
44. Blood Products
One unit of packed red blood cells, with a volume of 250-300 ml, should
increase adult hemoglobin by 1 gram and hematocrit by 3%.
Generally, 0.5 ml of a unit of packed red blood cells should replace 1 ml
of estimated blood loss.
Packed red blood cells are concentrated and have a hematocrit of 70-
80%.
Whole blood will usually have a hematocrit of 40%.
If whole blood is used to replace estimated blood loss, then infuse 1 ml
of whole blood for each ml of blood loss