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Intravenous fluid selection rationales in acute clinicalmanagement

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Wing Yan Shirley Cheung, Wai Kwan Cheung, Chun Ho Lam, Yeuk Wai Chan, Hau Ching Chow, Ka Lok Cheng, Yau Hang Wong, Chak Wah Kam

 

Accident and Emergency Department, Tuen Mun Hospital, Hong Kong, China

 

Corresponding Author: Cheung Wing Yan Shirley, Email: scheung1031@gmail.com

 

© 2018 World Journal of Emergency Medicine

 

DOI: 10.5847/wjem.j.1920–8642.2018.01.002

 

BACKGROUND: Intravenous fluid (IVF) is commonly used in acute clinical management. This study aimed to review the choice and primary considerations in IVF prescriptions and to evaluate the adequacy of guidelines and trainings on it in the New Territories West Cluster (NTWC) of Hong Kong.

METHODS: This is a descriptive study based on data collected from an online survey. Data were processed by SPSS for statistical analysis. This study focused on a general description and doctor-nurse between group comparison. Participants were asked the choice of IVF for nine acute clinical scenarios and provide reason. A 1–10 scale was used to assess the sufficiency of guideline, training and information, and time for revision on IVF prescription.

RESULTS: 0.9% sodium chloride was the most familiar IVF (36%), followed by 5% Dextrose solution (26%). In the nine scenarios, the most chosen IVF was 0.9% sodium chloride (37%–61%). There was significant difference in the choice of IVF between doctors and nurses in 7 cases. The second most chosen IVF for doctors was Plasma-Lyte A while that for nurses was Gelofusine. Departmental practice was the most chosen reason to account for the prescription. The adequacy of guideline, information and training, and time for revision was rated 5. Doctors had significantly more time at work than nurses to update knowledge in IVF prescription (5.41 versus 4.57).

CONCLUSION: 0.9% sodium chloride was mostly chosen. The choice of IVF was mainly based on departmental practice. Adequacy of guideline, information and training, and time for revision on IVF prescription were average, indicating significant training deficit.

(World J Emerg Med 2018;9(1):13–19)

 

KEY WORDS: Intravenous fluid; Acute care; Resuscitation

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