practical guidelines on fluid therapy pdf

Resuscitation: this is for patients needing IV fluids urgently to restore circulation to vital organs following loss of plasma in the blood (intravascular volume).

The five RsĪ key recommendation of the guideline is that all health professionals involved in prescribing IV fluids should use the new “five Rs of IV fluid therapy”: It should cover the importance of monitoring patients on IV fluid therapy, the need for ongoing assessment and reassessment, and the signs and symptoms that may suggest a complication. The NICE guideline recommends that such training should be developed and made available to all health professionals involved in prescribing, administering and monitoring IV fluid therapy. Training is generally provided to nursing staff to enable them to give IV medications, including IV fluid therapy, little training is available in acute settings specifically on IV fluid therapy. Once mandatory and necessary specialist training needs are met, resources to support further specialist training in areas such as IV fluid therapy are limited.

There are many competing priorities for mandatory and other specialist training in acute hospitals. Receiving the wrong type of fluid could result in an imbalance of electrolytes, which could lead to other potentially life-threatening complications. NICE has called for doctors and nurses to be better educated to help them avoid errors that can lead to serious complications, such as acute kidney injury (AKI), which may be a consequence of receiving too little IV fluid, or heart failure, which may be due to receiving too much fluid. As many as one in five patients on IV fluid therapy may experience complications as a result of being given too much, too little or the wrong type of fluid, with some complications proving fatal (National Confidential Enquiry into Perioperative Deaths, 1999). Improving practiceĪlthough IV fluid therapy is often thought of as routine with few consequences, it carries many risks as well as benefits.Īll IV fluids are drugs requiring a prescription, and can have serious negative effects if not given correctly. The National Institute for Health and Care Excellence has published a guideline, Intravenous Therapy in Adults in Hospital, to improve patient safety in this area (NICE, 2013).

Greater attention to IV fluid therapy is needed in nurse education and it should be prioritised in continuing professional development. This leads to nurses considering IV fluid therapy as “routine” and often being unaware of its importance, benefits and associated risks. Despite this, there is often a lack of formal training for nurses and other health professionals, before or after registration, in prescribing and administering and managing this complex therapy.

Practical guidelines on fluid therapy pdf