MONITORING THE IV FLUID THERAPY PATIENT AMY NEWFIELD, CVT, VTS (ECC)
In the VETgirl veterinary technician learning track webinar, “Monitoring the IV Fluid Patient,” Amy Newfield, CVT, VTS (ECC) reviewed appropriate monitoring of the IV fluid therapy patient.
KEY HIGHLIGHTS
Fluid therapy is perhaps one of the most common drugs we give in veterinary medicine. We often don’t think about how it’s not benign. We have to remember that any intravenous fluid is a drug and drugs, no matter the kind, are not benign. Being aware of common complications and how to monitor a patient on fluid therapy is the difference between life threatening complications and not. Fluid therapy is generally indicated in most hospitalized patients, even those that are healthy and undergoing small minor procedures, like a laceration repair. There are certain conditions where aggressive fluid therapy or perhaps even no fluid therapy may be indicated. Contradictions for aggressive/ no fluid therapy include: heart disease, pulmonary contusions/edema and brain injuries. In these patients if fluid therapy is necessary then it must be done so cautiously and patients must be monitored very closely. 1 FLUID OVERLOAD & DEHYDRATION Patients should be constantly monitored for both fluid under-hydration and fluid over-hydration (dehydration and overload). While the later is more common, it is equally important to watch for excessive fluid losses or signs that dehydration may not be corrected in a timely fashion. It is important to alert the veterinarian in changes of a patient’s status that result in fluid loss such as vomiting, diarrhea or reluctance to eat/
moves the drip rate changes. Since it is generally impossible to get patients to stay completely still, the drip rate you initially calculated out will change, causing the patient to receive more or less fluids then the desired rate. Fluid administrative pumps should always be used to help avoid mistakes in fluid flow rates. 3 WEIGH YOUR PATIENT Patients should be weighed at the beginning of treatment and then at least two times a day to determine fluid gains and losses. Rapid changes in body weight are usually a result of fluid gains or losses. A 0.5 kg weight gain is equivalent to a 0.5 liter fluid gain. (continued)
drink. Dehydration signs include: tachycardia/bradycardia, dry mucous membranes, increase skin turgor, depressed mentation, sunken in eyes, hypotension. Fluid overload signs include: increased lung sounds, increased blood pressure, serous nasal discharge, pitting edema, chemosis (edema of the ocular conjunctiva). Using the below metrics to monitor how the patient is handling the fluids is key. 2 USE FLUID PUMPS Because the calculation of fluid volume is somewhat subjective, potential inaccuracies can occur. Gravity fed systems are not ideal and should only be used if there is no fluid pump. This is because every time a patient
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