ADULT INTRAVENOUS FLUID PRESCRIPTION CHART
WARD HOSPITAL
Enter Pa)ent Details or
CONSULTANT
Iden)fica)on Label
DATE OF ADMISSION WEIGHT HEIGHT Name:
Hospital number:
Date of Birth:
DATE WRITTEN Address:
NHS Number:
CHART___ of ___
Approximate daily healthy adult fluid and electrolyte requirements Daily Assessment
Sodium: 50-100 mmol/day 1. Does the pa8ent need IV fluids?
Potassium: 40-80 mmol/day 2. Check U&E’s done in last 24 hours
Fluid requirement: 1.5-2.5 litres/day 3. Check fluid balance
Fluid prescrip8on guidance
0.9% Saline: Na=154mmol/litre; 4% dextrose/0.18%saline: Na= 30mmol/litre
Date:
Hartmann's: Na= 131mmol/litre; K= 5mmol/litre.
• Hartmann's is a safe first choice in the ini8al 24 hours following Na
surgery and for ini8al volume replacement (except in liver failure)
K
• Replace abnormal GI losses with addi8onal premixed bags of 0.9% saline
and KCL
Urea
• For maintenance and standard diabe8c sliding scale fluid regimens:
consider the use of premixed bags of 4% dextrose/0.18% saline and Crea8nine
KCI according to daily assessment, at a maximum rate of
1 litre/12 hours (83mls/hour) in order to reduce the risk of hyponatraemia
• Never use 4% dextrose/0.18% saline for a fluid challenge/ resuscita8on
Prescrip)on Commenced
Date Fluid Addi,ves Volume Dura,on Sign and Bleep No. Date Time Batch No. Signature Signature
1 2