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Module 3 : Prescribing

 

 

Principles of fluid prescribing

 

The key to safe and effective prescribing is to have a thorough checklist in your mind. It is vital to remember a number of key principles whenever you pick up your pen to prescribe fluids!

 

1

Each patient and clinical scenario is unique. There is no place for blanket regimens such as “two sugar one salt”.

 

2

Each time you prescribe you should:

  • remember your basic physiology
  • perform a thorough clinical and biochemical assessment
  • consider yesterday’s fluid balance, and calculate todays predicted losses and gains

 

3

 

Well patients can osmoregulate better than you can do it for them. Patients should eat and drink if they are able to.

 

4

Remember that fluids can be dangerous. Especially in patients with heart, liver or renal failure. Always start with a small fluid challenge.

 

5

Never write up for long periods (eg >24hr). Always review the patient regularly!

 

6 If in doubt, ask a senior!

 

 

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