Assessing volume status relies more on interpreting trends than in absolute values: In rough order of importance:
- heart rate
- urine output
- CVP or liver size
- blood pressure
Fluid for resuscitation
The following fluids are used, but the preference may vary according to the consultant and the clinical situation.
0.9% saline: default solution - readily available.
4.5% human albumin: may be used in septic shock. No other indications. Order from blood bank for specific patients (small emergency supply on PICU). Any unused at the end of the patient stay must be returned.
Hartmann's solution: used if chloride is high
Use only 0.9% saline in trauma and head injury
If Hb < 10g/dL give blood (this applies to resuscitation phase only)