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Lecture notes

Fluid management in surgery

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This is a study guide written by me for Medical Students. The content will take them all the way through final exams. I am a medical doctor graduated in 2020 in the top 20% of my class; based off these revision notes.

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  • September 30, 2022
  • 2
  • 2019/2020
  • Lecture notes
  • Mr bennett
  • All classes

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Fluids in surgery

Resus

Maintenance

 Never forget to check if the patient is able to drink and increase their own fluid
intake to rehydrate before you make some one NBM or give them IV fluids.

 Check Hx, examination, observations, lab results (electrolytes, renal function,
liver function etc.)

Maintenance fluids – 25-30ml/kg/day of fluid
1mmol/kg/day potassium, sodium and chloride
50-100g/day glucose




NaCl with 40mmol of potassium, increases the chloride from 154 to 194mmol
because charges need to balance.

Losses/additions will need to be added or subtracted from the total fluid amount.
Medications made up in saline will need to be subtracted from the total amount.
TPN will need to be subtracted from the total amount of maintenance given.

Fluids Hx for balance

 Vomit losses
 Fluid intake orally
 Urine output (v important)
 Diarrhoea

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