1. IV Fluids Intravenous Fluids

3. Intravenous administration refers to the introduction of fluids directly into the venous blood stream.

4. IV Fluids:
Administrating sterile fluid into a Suitable vein which could be: -Arm vein e.g., Ante-cubital fossa, wrist…. -Scalp vein in an infant. -Other veins, ex saphenous vein…. ex. Burns through venesection

9. Aims (Indications) of intravenous fluids:
*(Water and electrolytes loss = gain).
1- To correct or prevent fluid and electrolyte imbalance (dehydration, bleeding, burn, post operation).
2- To correct or prevent nutritional imbalance.
3- To provide IV medication.

10. There are two components to fluid therapy:
1- Maintenance therapy: replaces normal ongoing losses.
Maintenance therapy is usually undertaken when the individual is not expected to eat or drink normally for a longer time (e.g., preoperatively, or on a ventilator).
2- Replacement therapy: corrects any existing water and electrolyte deficits.

11. In order to administrate iv fluid we need:

12. 1-The sterile Fluid:

13. 2-Container:
either a Plastic bag or Glass container

14. 3-IV infusion Set:
1-Insertion spike Drip chamber (filter) Rate Control clamp (regulator) Rubber injection portal Plastic tube Needle adaptor.
“Adult or pediatrics”

19. Pediatric Infusion Set

20. Infusion Pump

21. Infusion Pump

22. 4-Needle or Cannula
-Venesection set
Needle gage:
-Cannula
color

30. Indications of IV fluids???

31. 1-Dehydration In a patient who Can Not tolerate oral therapy or in severe cases.

32. 2-Hypovolaemic shock
-Bleeding.
-Burns.

33. 3-Post operative patients:
-After surgery

34. 4-Administration of drugs

35. 5-Parentral Nutrition Total Parenteral nutrition

36. Complications of IV fluids???

37. Complications of IV fluids:
1- Phlebitis, thrombophlebitis.
2- Sepsis.
3- Extravasation.
4- Air in tube/air embolus.
5-Glucose and electrolyte disturbances.
Na, k, Hypoglycemia, Hyperglycemia, Hyponitraemia
6- Circulatory overload, hypertension and pulmonary edema.
(rapid administration in pediatrics ,heart failure).

38. 1-Glucose and electrolyte disturbances: -Na, K -Hypoglycemia -Hyperglycemia -Hyponatremia ………..etc

39. 2-Circulatory disturbances:
-Heart failure
-Rapid administration.
Pediatrics

40. 3-Hypertension

41. 4-Local complications:
Thromophlebitis Cellulitis infections
Leaving cannula for more than 3 days:
-Redness
-Hotness
-Tenderness

43. Other less common complications:
-Septicemia
-Air embolism

44. Types of IV fluids:
1-Crystalloids:
-Water
-Electrolytes
-Glucose

45. 2-Colloids
“Plasma expanders”
Gelatin, starch……etc
Parentral nutrition

46. Colloids are a form of suspension of high molecular weight molecules.
Can be separated by physical means
Centrifugation
Albumin , Gelatin, Starch

47. Crystalloids:
Isotonic: mOsm/kg Osmotic pressure = normal body Hypertonic: higher than the body Hypotonic: lower than body

48. Isotonic Solutions:
1-Normal saline:
0.9 % NaCl

49. 2-Dextrose water 5 %
Glucose???

50. 0.9% 3-Dextrose Saline: 1/3 = 0.3 % NaCl + 5 % Dextrose

51. 4-Dextrose In saline:
0.9 % NaCl + 5 % Dextrose

52. 5-Compound sodium lactate solution
-Hartman's solution
-Ringers lactate solution
K, Ca, Lactate

53. One liter of lactated Ringer's solution contains:
  mEq of  sodium  ion  =   mmol/L
mEq of  chloride  ion = mmol/L
mEq of  lactate  = mmol/L
mEq of  potassium ion = mmol/L
mEq of  calcium  ion = mmol/L
Generally, the sodium, chloride, potassium and lactate come from NaCl (sodium chloride), NaC3H5O3 (sodium lactate), CaCl2 (calcium chloride), and KCl (potassium chloride).
There are slight variations for the composition for Ringer's as supplied by different manufacturers..
Although its pH is 6.5, it is an alkalizing solution.

55. Hypertonic:
-Hypertonic glucose 10% 20 % 50%

56. Mannitol:
-Mannitol 5% (isotonic) ( 10% 20%) Hypertonic -Brain edema -laxative

57. Mannitol Conc. (%) g/100 mL mOsmol/liter (calc.) pH* 5 274
549 15
823 20
1098 25
1372
5.9 (4.5 to 7.0)
Mannitol

58. When administered intravenously mannitol is confined to the extracellular space, only slightly metabolized and rapidly excreted by the kidney.
The drug is freely filtered by the glomeruli with less than 10% tubular reabsorption; it is not secreted by tubular cells.
Mannitol induces diuresis by elevating the osmolarity of the glomerular filtrate and thereby preventing tubular reabsorption of water.

59. Therapeutic Use of mannitol:
Promotion of diuresis in the prevention or treatment of the oliguric phase of acute renal failure before irreversible renal failure becomes established.
Reduction of intracranial pressure and brain mass.
Reduction of high intraocular pressure when the pressure cannot be lowered by other means.
Promotion of urinary excretion of toxic materials.

60. Dose calculation of IVF:
% of body is water
Blood is 5 liters:
Average adult requirement is 2-3 litters /24 hours ml

61. Drop Rate Calculation:
Each 1 ml = 15 drops
Each drop = 4 micro drops
Each 15 X 4 = 60 micro drop =1 ml

62. Drop Rate Calculation:
Fluid requirement in ml /24 hors
= Requirement in ml/100
drop / minute