Offer IV fluid therapy as part of a protocol (see the following algorithms for IV fluid therapy in the full version of the guideline document [see the “Availability of Companion Documents” field]): Assess patients’ fluid and electrolyte needs following Algorithm 1: Assessment. If patients need IV fluids for fluid resuscitation, follow Algorithm 2: Fluid resuscitation. If patients need IV fluids for routine maintenance, follow Algorithm 3: Routine maintenance. If patients need IV fluids to address existing deficits or excesses, ongoing abnormal losses or abnormal fluid distribution, follow Algorithm 4: Replacement and redistribution. Include the following information in IV fluid prescriptions: The type of fluid to be administered the rate and volume of fluid to be administered Patients should have greater than 45°. If, at 30–90 seconds, the patient shows signs of hemodynamic improvement, it indicates that volume replacement may be required. If the condition of the patient deteriorates, such as breathlessness, it indicates that the patient may be fluid overloaded. Assess the patient’s likely fluid and electrolyte needs from their history, clinical examination, current medications, clinical monitoring and laboratory investigations: History should include any previous limited intake, thirst, the quantity and composition of abnormal losses (see “Diagram of Ongoing Losses” in the full version of the guideline document), and any comorbidities, including patients who are malnourished and at risk of refeeding syndrome (see Nutrition support in adults External Web Site Policy [NICE clinical guideline 32]).
