![]() ![]() These higher amounts contribute greatly to the insensible losses of fluid in the pediatric patient. These differences include higher metabolic rates, caloric expenditure, body surface area, and respiratory rates. Due to physiological differences in pediatric patients, fluid therapy can vary widely. Pediatrics are sensitive to fluid and can be overloaded, leading to electrolyte imbalances, kidney dysfunction, and cardiovascular failure. ![]() ![]() Well, that is the worst answer you can pick, especially when dealing with the pediatric population. I remember in paramedic school, any answer in regards to fluid administration was always “titrate to effect”. Remember maintenance fluid calculations are NOT for our hypovolemic patients. I know what you’re thinking…WE DON’T RESUSCITATE WITH PASTA WATER, BLOOD BLOOD BLOOD! Lucky for you, we’re talking maintenance, not trauma resuscitation. These bolus fluids are indicated for patients suffering from gastrointestinal illness, poor oral intake, or traumatic injuries where hemodynamic status is compromised. Prehospital providers are drilled with the standard PALS formula for fluid resuscitation, 20ml/kg, or 10ml/kg for infants. “Maintenance intravenous fluids (IVFs) are used to provide critical supportive care for children who are acutely ill… they should only be administered when clinically indicated.” (Feld et al.) Although these calculations are utilized in the hospital/critical care setting, they are fundamental in treating pediatrics in any realm. Planning to take one of these certification tests? I can guarantee that you will have to know these calculations. This stress usually appears while you are handing over $300 and sitting down for your FP-C or CFRN board exam. Pediatrics, calculations, fluids, maintenance, hypotonic, isotonic?!?! These words bring on a new type of stress. ![]()
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