TY - CHAP M1 - Book, Section TI - Chapter 4. Fluids, Electrolytes, and Acid-Base Disorders 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. Y1 - 2012 N1 - T2 - Tintinalli's Emergency Medicine Manual, 7e 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. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/04/19 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=56271315 ER -