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Contents & Uses of common IV fluid

Contents & Uses of common IV fluid. Simple JMS set. Indications – IV fluid administration crystalloid/ colloid 20 drops = 1ml Set up Assemble & hang from drip stand over sink Clamp the regulator Insertion pin into fluid bag Fill half the drip chamber Then expel all the air in the tubing

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Contents & Uses of common IV fluid

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  1. Contents & Uses of common IV fluid

  2. Simple JMS set • Indications – IV fluid administration crystalloid/ colloid • 20 drops = 1ml • Set up • Assemble & hang from drip stand over sink • Clamp the regulator • Insertion pin into fluid bag • Fill half the drip chamber • Then expel all the air in the tubing • Problems – fluid emptied, air in tubing, full drip chamber • Limitations – rate limited by gravity / angio size / tube length, cannot give blood

  3. Factors affecting fluid flow rate Poiseuille's Law Calculation

  4. Factors affecting fluid flow rate • Resistance to fluid flow • eg tube length / diameter of CAIR clamp/ tubing size, • angiocath size, • fluid viscosity eg blood versus crystalloid • Pressure gradient • ie gravity • pressure bag etc, • Student practice • Use of flow regulator • Addition of thin extension tubing • Alter position (height) of bag • Compare different canulae: 24 / 20 / 16 gauges

  5. Pump set • Clamps / flow regulators to control flows • 2 piercing pins • Filter to filter out clot/ fragments when giving blood; drip chamber • Pump chamber (20 compression  500ml; 40 ml/each) • One-way ball valve • Tubing with larger calibre • Change every 24hrs

  6. Pump-set • Indications • Massive blood loss resuscitation eg trauma, surgery, severe burns, rapid rehydration etc • Rapid intravenous fluid administration • Administration of blood products • Limitations • Flow rate limit • Blood clot fragment • Change every 24hrs • 2 piercing ports  risk of administered incompatible fluid or drugs • Problem solving : Air in tubing, full chamber

  7. Burette Set - Indications • Administration of intravenous fluid • Paediatric patient • Administration of drugs • Antibiotics eg gentamicin, amikacin, vancomycin etc • Inotropes infusion : adrenaline, noradrenaline, dobutamine, dopamine • Phenytoin • MS practice • Use of reservoir chamber (Fill / prevent over fill) • Trap door (Purposed & how to open) • Drip chamber (setting up) • Control flow rates • Remark : • Burette 100 ml with flashback device, need to change every 48 hrs, 60 drops / ml

  8. 100ml Burette IV set • Set up • Clamp all clamps / regulators • Fill up the chamber to desired volume • Open distal clamps to expel air • Limitations • Not for blood product • Not for rapid infusion

  9. CVP manometer • Method • Connect simple set to Manometer & fluid reservoir • Fill up the system & manometer (red ball index) • Ensure catheter is not blocked or kinked • For Practice • priming manometer tubing & measuring fluid level • Landmarks • Need a zero point (right atrium) mid-axillary line 4th intercostals space supine • RA filling pressure  assess volume adequacy • Trend is more useful (importance of same position each time) • Complications : Air embolism, bleeding, sepsis

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