Table 1

Standards for intravenous fluid choice as per National Institute for Health and Care Excellence (NICE) guidelines

Intravenous fluid indicationNICE guidelines
Maintenance

  1. 25–30 mL/kg/day of water.

  2. Approximately 1 mmol/kg/day of potassium, sodium and chloride.

  3. Approximately 50–100 g/day of glucose to limit starvation ketosis.

(In other words, 0.18% normal saline with 4% dextrose with no more than 1 L of either Hartmann’s or normal saline per 24 hours.)
Resuscitation

  1. The cause of the fluid deficit is identified.

  2. A fluid bolus of 500 mL of crystalloids is given.(In other words, a bolus of Hartmann’s or normal saline.)

  3. Patients who have received initial fluid resuscitation are reassessed using the ABCDE approach.

  4. Patients who have already been given >2000 mL of crystalloids and still need fluid resuscitation after reassessment receive expert help.

  5. Patients who have not had >2000 mL of crystalloids and who still need fluid resuscitation after reassessment receive 250–500 mL of crystalloids and have a further reassessment using the ABCDE approach.

ReplacementNot listed as standard in NICE guidelines.
Intravenous fluid of choice for losses should be normal saline or Hartmann’s.