Shock fluid rates

Re: Shock fluid rates

sarah collins — Sat, 06 Jul 2013 15:52:14 GMT

The main thing to remember is that although the textbooks quote 90ml/kg for shock cases, not every case is the same, and it would not be recommended to just set up fluids at 90ml/kg/hr and walk off and leave your patient. If a patient is in that degree of shock then you should be continuously monitoring it, and assessing fluid status. If you give 10ml/kg boluses over 10 mins then that MAKES you assess the situation as the pump is beeping at you, and you can decide if another bolus is needed. You continue this way until the patient is looking more stable and you can go down to lower rates. Some cases will need the full 90ml/kg or more (GDV cases for example), but many will not and it is safer to give in increments than risk over infusing. Hope this helps!

Re: Shock fluid rates

Laura Moss — Sat, 06 Jul 2013 02:17:10 GMT

there seems to be a great difference between 90mls/kg/hr and if ypu calculated it 40mls/kg/hr but is it better not to over infuse? i guess if you was monitoring the bp then would you increase it to more like the 90mls/kg/hr? do you tend to do cats over 20/30mins?

thanks fot your reply

Re: Shock fluid rates

sarah collins — Fri, 05 Jul 2013 22:46:17 GMT

Textbook shock rates are 90ml/kg, which is basically circulating blood volume BUT I would never give this as one massive bolus as once it's in it's difficult to get it out again! Fluids should be given in 10ml/kg boluses over 10-15mins in canine shock cases where indicated, and the patient should be really closely monitored during this time. Boluses can be repeated as nessesary, but often you will not need the full 90ml/kg. In cats you need to be particularly carefull as the smaller the patient the easier it is to overinfuse.

Re: Shock fluid rates

Laura Moss — Fri, 05 Jul 2013 21:37:59 GMT

but if it was a 20kg dog it would need 1800mls/hr so it could not give it at this speed , does this matter? also been told to give a slower rate for cats is this true?

thanks

Re: Shock fluid rates

Nick Shackleton — Fri, 05 Jul 2013 20:22:38 GMT

Example: 10kg dog 90x10=900mls. So set your rate a 900mls/hr if over this set to 999mls/hr. for smaller patients your VTBI and Flow Rate should match, so a 5kg dog/cat would be infused with 450mls over 1hr at a rate of 450mls/hr Set VTBI as 900mls. Once this has been infused the patient should be assessed for response to fluids

Re: Shock fluid rates

Laura Moss — Fri, 05 Jul 2013 16:45:44 GMT

what digits does your fluid pump go to?

Re: Shock fluid rates

Emma Gerrard Dip AVN (SA) DipHe CVN BSc (Hons) CVN RVN KSQP RAM — Fri, 05 Jul 2013 13:18:34 GMT

not a silly question at all. we would use 90ml/kg/hr as a shock rate for both. Usually for 1-2 hours initially and then titre to needs and obs. We also use a fluid pump, but havnt had any issues with amount it will let you use.