RT Book, Section
A1 Wittler, Mary A.
A2 Cline, David M.
A2 Ma, O. John
A2 Cydulka, Rita K.
A2 Meckler, Garth D.
A2 Handel, Daniel A.
A2 Thomas, Stephen H.
SR Print(0)
ID 56271315
T1 Chapter 4. Fluids, Electrolytes, and Acid-Base Disorders
T2 Tintinalli's Emergency Medicine Manual, 7e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-178184-8
LK accessemergencymedicine.mhmedical.com/content.aspx?aid=56271315
RD 2024/04/19
AB When  altered,  fluids  and  electrolytes  should  be  corrected  in  the  following  order:  (a)  volume;  (b)  pH;  (c)  potassium,  calcium,  and  magnesium;  and  (d)  sodium  and  chloride.  Reestablishment  of  tissue  perfusion  often  equilibrates  the  fluid-electrolyte  and  acid-base  balances.  Because  the  osmolarity  of  normal  saline  (NS)  matches  that  of  serum,  it  is  an  excellent  fluid  for  volume  replacement.  Hypotonic  fluids  such  as  5%  dextrose  in  water  (D5W)  should  never  be  used  to  replace  volume.  Lactated  Ringer  solution  is  commonly  used  for  surgical  patients  or  trauma  patients;  however,  only  NS  can  be  given  in  the  same  line  with  blood  components.  D5½NS,  with  or  without  potassium,  is  given  as  a  maintenance  fluid.  The  more  concentrated  dextrose  solutions,  D10W  or  D20W,  are  used  for  patients  with  compromised  ability  to  mobilize  glucose  stores,  such  as  patients  with  hepatic  failure,  or  as  part  of  total  parental  nutrition  solutions.