part 3 medication administration body fluid composition ems 353 lecture 8 dr. maha khalid
TRANSCRIPT
Part 3 Medication Administration
Body Fluid Composition
EMS 353 Lecture 8
Dr. Maha Khalid
Contents ……
Body Fluid Composition
Electrolytes.
Abnormal States of Fluid and Electrolyte Balance.
IV Fluid Composition .
IV solution .
Purpose of IV Solutions
Pre hospital Fluids :
Lactated Ringer’s
Normal saline solution
5% dextrose in water .
8. Other fluids
9. Packaging of IV Fluids
Body Fluid Composition
Total body water (TBW) is 60% of adult weightIntracellular fluid (ICF): 45% Extracellular fluid: 15%
Interstitial fluid Intravascular fluid
Fluids are composed of solutions (solvent and solute).
Interstitial fluid (or tissue fluid) is a solution that bathes and surrounds the cells of multicellular animals. It is the main component of the extracellular fluid, which also includes plasma and transcellular fluid. The interstitial fluid is found in the interstitial spaces, also known as the tissue spaces.
Body Fluid Composition
ElectrolytesCarry charges
Reactive and dangerous if left to circulateWater stabilizes electrolytes charges.
Cation: positively charged
Anion: negatively charged
Body Fluid Composition
Electrolytes (cont’d)Measured by milliequivalent
(mEq)1 mEq of a cation can react
completely with 1 mEq of an anion.
Singly charged: monovalent Doubly charged: bivalent
Electrolytes
Mg
NaK
Ca
Cl
Electrolytes
Add Your TextBicarbonate
Phosphorus
Sodium
• Regulates distribution of water
Potassium
• Major role in neuromuscular function and conversion of glucose into glycogen
Sodium-potassium pump
• Helped by insulin and epinephrine• Hypokalemia: low serum levels • Hyperkalemia: high serum levels
Calcium
• needed for bone growth • Hypocalcemia: low serum
levels• Hypercalcemia: high serum
levels
Magnesium
• metabolizes proteins and carbohydrates.
Bicarbonate:
• determines metabolic acidosis and alkalosis
Chloride
• regulates the pH of the stomach
Phosphorus
• important component in adenosine triphosphate (ATP)• ATP: the body’s energy
source
metabolic acidosis
In medicine, is a condition that occurs when the body produces too much acid or when the kidneys are not removing enough acid from the body. If unchecked, metabolic acidosis leads to acidemia, i.e., blood pH is low (less than 7.35) due to increased production of hydrogen ions by the body or the inability of the body to form bicarbonate (HCO3-) in the kidney. Its causes are diverse, and its consequences can be serious, including coma and death. Together with respiratory acidosis, it is one of the two general causes of acidemia
Metabolic alkalosis
Metabolic alkalosis is a metabolic condition in which the pH of tissue is elevated beyond the normal range ( 7.35-7.45 ). This is the result of decreased hydrogen ion concentration, leading to increased bicarbonate, or alternatively a direct result of increased bicarbonate concentrations
Abnormal States of Fluid and Electrolyte Balance:
A healthy body maintains a balance between intake and output of fluids and electrolytes. Homeostasis: internal environment’s
resistance to change
A healthy person loses approximately 2 to 2.5 L of fluid daily.
Abnormal States of Fluid and Electrolyte Balance
Dehydration is an inadequate total systemic fluid volume.Causes:
Diarrhea
Vomiting
Gastrointestinal drainage
Infections
Metabolic disorders
Abnormal States of Fluid and Electrolyte Balance
Over hydration occurs when the body systemic fluid volume increases.
Causes:Unmonitored IVs
Kidney failure
Water intoxication in endurance sports
Prolonged hypoventilation
© Medical-on-Line/Alamy Images
IV Fluid Composition
Each bag of IV solution is individually sterilized.Altering IV
concentration can move water into or out of fluid compartment
IV solution
CrystalloidColloid
clear fluids made up of water and electrolyte solutions;
Will cross a semi-permeable membrane e.g Normal, hypo
and hypertonic saline solutions; Dextrose
solutions; Ringer’s lactate and Hartmann’s solution.
Gelatinous solutions containing particles suspended in solution. These particles will not form a
sediment under the influence of gravity and are largely unable
to cross a semi-permeable membrane. e.g. Albumin,
Dextrans, Hydroxyethyl starch [HES]; Haemaccel and
Gelofusine
Blood Volume–Expanding Solutions
• Crystalloid solutions– Isotonic: Same tonicity as human blood– Examples: Normal saline, lactated Ringer’s– Hypotonic: Lower concentrations of
electrolytes than blood – Hypertonic: Higher concentrations of
electrolytes than blood • Colloid solutions
– Use undergoing debate
Purpose of IV Solutions
Replacement of Lost Fluids (vomiting, diarrhea, dehydration)
Maintenance of Fluid and Electrolyte Balance
(NPO patients)
Prehospital Fluids
Lactated Ringer’sNormal saline solution5% dextrose in water
Other FluidsBloodOxygen-carrying solutions
Perfluorocarbons
Hemoglobin-based oxygen-carrying solutions (HBOCs)PolyHeme
Hemopure
1) 0.9% Normal Saline
• Think of it as ‘Salt and water’• Principal fluid used for intravascular
resuscitation and replacement of salt loss e.g diarrhoea and vomiting
• Contains: Na+ 154 mmol/l, K+ - Nil, Cl- - 154 mmol/l; But K+ is often added
2) Lactated Ringer's solution
• is a solution that is isotonic with blood and intended for intravenous administration. It may also be given subcutaneously. Lactated Ringer's solution is grouped with intravenous fluids known as "crystalloids" – which include saline and dextrose solutions
3) 5% Dextrose
Think of it as ‘Sugar and Water’Primarily used to maintain water balance in patients who are not able to take anything by mouth
Packaging of IV Fluids
Most packaged in soft plastic or vinyl bags
Container provides important information: Label lists fluid type and expiration date
Medication administration port
Administration set port
IV Solution Containers
Do not use any IV fluids after their expiration date; any fluids that appear
cloudy, discolored, or laced with particulate; or any fluid whose sealed
packaging has been opened or tampered with.