Vn

1. To provide and maintain daily maintenance fluid requirements. 2. To correct dehydration by supplying fluid deficit. 3. To replace essential electrolytes. 4. To provide a vehicle for intravenous medications 5. In emergency fluid or blood replacement following shock or haemorrhage. 6. To control hypovolaemia and maintain blood pressure during surgery. REASONS FOR FLUID THERAPY

ICF (40% of BWT)ECF (20% of BWT) Intersitial fluid Plasma 15% BWT 5% BWT FLUID COMPOSITION OF THE BODY TOTAL BODY FLUID =60% OF BWT

Per os S/C I/P I/V I/O Only I/V and I/O suitable for severe shock or dehydration ROUTES OF FLUID ADMINISTRATION

Accessible veins in different species Avoidance of damaged veins, phlebitis or veins that would cause catheter flexion as joints move Duration of catheterisation Limb catheters are less likely to cause serious complications but jugular catheters are well tolerated and may be suited to chondrodystrophic dogs and mobile patients that tend to tangle limb catheters FACTORS AFFECTING THE CHOICE OF VEIN

BUTTERFLY CATHETERS

OVER THE NEEDLE CATHETERS

Seddinger over the wire catheter JUGULAR CATHETERS

PEEL AWAY CATHETERS

Gauge Should be the largest that does not cause damage to the vein or thrombosis due to inadequate flow past the catheter Catheter length Longer is more stable but it must not be so long it kinks at the flexion of a joint or enters the heart CATHETER GAUGE AND LENGTH

standard surgical prep required for the site and administrator hands avoid clipper burn and ensure the site is dry before placement PREP OF THE SITE

60 drop per ml sets should be used for patients under 10kg Paediatric burettes can be inserted in the line for accurate delivery of small volumes Plugs 3 way taps and t-port connectors can be used to allow the set to be disconnected at times FLUID SETS

Use page 6 of your notes to make a poster about safety and trouble shooting the drip SAFETY PRECAUTIONS AND TROUBLE SHOOTING THE DRIP

Chrystalloids Isotonic 0.9%saline, LRS/hartmanns Hypertonic 7%saline solution crenation Hypotonic 5% dextrose in water haemolysis Colloids Used to correct hypovolaemia /hypoprotienaemia Tend to cause platelet and clotting function problems Dextran and hetastarch CHOICE OF FLUIDS

Physical exam observations can give an estimate of hydration status to use in calculation of fluid deficit/rehydration volume required Or PCV can be used to evaluate the fluid deficit Maintenance fluid can be estimated at 50 mls/kg /day Ongoing losses are estimated from observed losses from vomiting diarrhoea and extra urinary losses due to the disease condition PATIENT ASSESSMENT AND CALCULATION OF FLUID REQUIRED

Monitor for over infusion, phlebitis, fluids that have stopped flowing, infection and correct placement of the catheter in the vein MONITORING THE DRIP