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Module 2 : Clinical Assessment



Clinical assessment of fluid status


Assessing a patient’s fluid status in clinical practice is somewhat of an imprecise science, however in order to gauge this as correctly as possible, it is important to be able to recognise the clinical signs and know which tools are available. It is also important to appreciate that no one clinical sign or observation is pathognomonic of fluid deficit or overload, rather all information is collated in order to build a wider picture.


To aid assessment of a patient’s fluid status one may look at the following;


1.    Patient history

2.    Clinical examination of the patient

3.    Fluid balance charts

4.    Weighing the patient

5.    Blood biochemistry


Note that more accurate means of assessing fluid balance do exist. These include central venous catheterisation and other invasive monitoring. This tends to be used in critically ill patients and intraoperatively if the patient is at high risk of complications. The methods of assessment discussed here are those you are likely to see on the general medical and surgical wards.



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