Re: Mark Lee

Dear Mark Lee,

Basically, the fluid management for children (& elderly) is MORE tedious as compared to an adults'. Having said that, its' not wrong (in fact, it is better) to actually use the formula used for management of fluids in a child on an adult.

However, since adults have a better tolerance of fluids imbalance as compared to a child, they are able to take (slightly) more/less of fluids than the body needs if given by any physician.

Therefore:

1) The clinical manifestations of dehydration can still be used in an adult (the table in my previous pdf file.)

2) However, the initial resuscitation steps for an adult during the ABC need NOT use the 20ml/kg body weight formula. Just run a pint (500ml) of Hartmann's solution or Normal Saline and check for the patients' haemodynamic status after each pint. Repeat this until the patient is stable. (you don't need to count to the exact amount of fluids needed as compared to a child.)

[NB: For extreme ages (children & elderly), the imbalance of fluid tolerance levels are less. This means that for this age groups, it’ll be VERY wise to provide the amount of fluids that is loss or needed, no more or less. So, you'll have to calculate the fluids needed in this age group.]

3) The formula to estimate maintenance requirements still remain the same for an adult as for a child.

[NB: For young adults who you decide to be less accurate in the management of fluids, do LOOK OUT for signs & symptoms of fluid overload, most notably-pleural oedema.]