Maintenance fluid requirements in children

• 1st 10kg of bodyweight at 100ml/kg/day
• 2nd 10kg of bodyweight at 50ml/kg/day
• Remaining bodyweight at 20ml/kg/day

The fluid type routinely used is 0.9% sodium chloride + 5% dextrose. Potassim is added as required depending on their U&Es.

Paediatric electrolyte requirements

• Sodium: 2-4mmol/kg/day
• Potassium: 1-2mmol/kg/day

Acute fluid resuscitation in children

• Boluses in paediatrics are given at 10-20ml/kg at a time
• The fluid used is 0.9% sodium chloride
• 10ml/kg boluses should be used when treating children who are in heart failure or are trauma victims
• Senior support should be sought if a child has not responded to 2 boluses

Fluids deficit replacement in children

• Firstly you should calculate the percentage dehydration. This is done either by one of the following ways:
  • If their normal weight is unknown: Estimating their level of dehydration based on clinical signs from a fluid (hydration status) assessment
  • If their normal weight is known:
    1. subtracting their current (dehydrated) weight from their normal weight
    2. dividing the result by their normal weight, and then
    3. multiply it by 100
• You can then work out the fluid deficit (in ml) by: weight (kg) x % dehydration x 10
• Deficit replacement fluids should then be given spread out over a 24-48 hour period in children in addition to normal maintenance fluids