Choosing the right fluid, volume and rate for a patient.
Key points
• First decide the need: resuscitation, routine maintenance, replacement or redistribution.
• Resuscitate shock with an appropriate crystalloid bolus, the volume tailored to the patient's condition and local protocol, and reassess after each bolus.
• Maintenance is roughly 25-30 mL/kg/day of water with added sodium, potassium and glucose.
• Reassess clinically and with U&Es; avoid overload and dilutional hyponatraemia.
Memory trick
The 5 Rs - Resuscitation, Routine maintenance, Replacement, Redistribution, Reassessment.