Interpreting the fluid requirements of a patient and working out what to do next can seem like a daunting task for the non-specialist, yet it is a skill that any doctor, nurse or paramedic needs to be fully appraised of and comfortable with.
Making Sense of Fluids and Electrolytes has been written specifically with this in mind, and will help the student and more experienced practitioner working across a variety of healthcare settings to understand why fluid imbalance in a patient may occur, to assess quickly a patient's fluid needs through a thorough clinical assessment and to develop an effective management plan. Reflecting the latest guidelines, this practical, easy-to-read and easy-to remember guide will be an invaluable tool to aid speedy and appropriate management in emergency situations, on the ward and in the clinic.
Features
Focuses on rapid assessment and appropriate action
Serves as a rapid reference in a variety of healthcare settings
Describes the fluid balance assessment and management responsibilities of the entire healthcare team
Uses diagrams, tables, and tips to provide speedy access to key information and advice on when to act quickly or consider seeking help
Table of Contents
How to use this book
Chapter 1 - Fluid Assessment
Chapter 2 - Keeping the Balance: Physiology, Electrolytes and Intravenous Fluids
Fluid Compartments
Description & Summary of fluid compartments
Fluid intake and output
Movement between Fluid Compartments: Cell membrane and Capillary filtration
Renal Physiology
Nephron
Hormones
Renal Electrolyte handling
Intravenous Fluids
Introduction
Types of IV fluids - Colloids
Types of IV fluids - Crystalloids: Isotonic, Hypotonic, Hypertonic
Electrolyte abnormalities
Definitions
Chapter 3 - Cardiac Arrest and Shock
Introduction
Assessment
Cardiac Arrest (Identification and management)
Shock
Distributive (including septic, anaphylactic)
Hypovolaemic (including haemorrhagic)
Cases
Chapter 4 - Intravenous Fluid Therapy in Medical Patients
Introduction
Medical Considerations in Fluid Assessment and Management
IV Fluid Therapy in the Context of Specific Medical Presentations:
Fluid depletion:
Acute Kidney injury
Diarrhoea and vomiting
Burns
Rhabdomyolysis - Covered in the Acute Kidney Injury section
Diabetic ketoacidosis - Covered in a case, see end of chapter
GI Bleeding - Covered in a case, see end of Chapter 6
Fluid Overload
Congestive cardiac failure - including Right and Left heart failure, Pulmonary oedema
Liver failure and ascites
Chronic Renal Failure - Covered in the Acute Kidney Injury section
Complex Fluid States
Hepato-renal Syndrome
Hypercalcaemia of malignancy - covered in case
Hyponatremia - in Chapter 2 electrolyte section
Other fluid states:
Fluids at the end of Life
Fluid therapy in the elderly
Conclusion
Chapter 5 - Fluid therapy management in Surgical Patients
Introduction
Pre-operative fluid status management
Role of bowel preparations
Special considerations
Intra-operative fluid balance
Post-operative fluid status management
Role of enhanced recovery programmes
Special considerations in subspecialties; e.g. bladder irrigation in urology, ileostomy effects.
Cases
Chapter 6 – Blood Products and Transfusion
Introduction
Assessment
Blood Products and Plasma Derivatives
Types
Indications
Special considerations.
Transfusion regimes
Cases
Dr. Zoja Milovanovic, Dr. Abisola Adeleye, and Dr, Douglas Corrigall are junior doctors in London, UK.
Dr. Tom Gilkes, Dr. Shilpa Reddy and Dr. Stefanie Robert are consultant anesthetists at Homerton Hospital, London, UK.
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