Making Sense of Fluids and Electrolytes

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.