Thank you so much for this. I was feeling so overwhelmed by the amount of information we got at the start of our Intensive and Specialized Care module, that I would be so lost whenever they would talk about fluid management in ICU patients. I am glad I got to watch this video.
Thank you for this video! It is very informative. As a side note, for fluid resuscitation in burn patients, the Rule of Tens is a better equation than the Parkland Formula for inpatient management. for pts 40-80kg: TBSA% x 10mL/hr = starting rate; for pts >80kg, 100mLs is added for every 10kg over the 80kg. The rate is then adjusted hourly by 20-25% based on the target urinary output of 30-50mL. (A higher target of 50-70mL is used for electrical injuries.) The Modified Brooks Formula is also readily used in burn patients. If you really want to get into the weeds, look up "Ivy Index" on why we would consider these alternative formulas.
Very great video. Now I understand the fluid maintenance calculation. The only mistake you did is when using 100:50:20 rule for a patient weighs 75kg the fluid needed for a day is 2600 ml and not 2700 ml. thanks again for your marvelous video
Thankyou so much for it. I have started my residency in Anesthesia, ev one was talking about this 4:2:1 rule, as i watch your videos regularly i was expecting that you might have covered this topic, & here it goes 🙌🏻 Thankyou for the great work 🙌🏻
Thanks so much for awesome videos and information! I’ve been waiting for this Fluid/electrolyte series from you, and I knew it would be great! Question: I work in Peds, but we do have adult size patients/or heavy patients, and we typically cap their Maintenance Fluids at 100-120ml/h, even if the 4/2/1 calculation suggests more than that. Is there a cap for adults? I know you mentioned we can use their IBW, but I’m just curious if there’s a cap when they reach a certain weight. Thanks!!
Thanks for sharing. I have a question. According to the regimen, do you worry about the vasculitis due to high osmolality of using D5S only? In our hospital, we usually use 5%dextrose+1/2normal saline. What's your opinion? Thank you very much.
@@Susan__g so awesome! Congrats on the new ICU position by the way. How exciting. It really means to world to me that these lessons are helpful for you and others. I really appreciate you taking the time to let me know. ❤️ I’m always happy to help when I can. Feel free to send any questions or even just updates on how things are going. You can find my email on the main UA-cam page about section. Wish you all the best! 😊
As someone aspiring for ICU this channel is really great to listen to to re-inforce and learn on key points. Thank you! Quick question, how do you typically calculate ideal body weight for a bedbound patient in ICU?
Awesome to hear David! Thanks for being a part of the channel! And good question. It depends which formula you use, but essentially you take whether they are male or female and use their height. Its then a simple calculation (or lookup table) to determine what the IBW is.
Remember certain populations will have limits or specific needs. Cardiac populations are ones that we want to be very conservative with fluids, so that makes complete sense
Thank you so much for this. I was feeling so overwhelmed by the amount of information we got at the start of our Intensive and Specialized Care module, that I would be so lost whenever they would talk about fluid management in ICU patients. I am glad I got to watch this video.
I have recently discovered this channel amd I am totally impressed by your work, thanks alot.
Thank you for this video! It is very informative. As a side note, for fluid resuscitation in burn patients, the Rule of Tens is a better equation than the Parkland Formula for inpatient management. for pts 40-80kg: TBSA% x 10mL/hr = starting rate; for pts >80kg, 100mLs is added for every 10kg over the 80kg. The rate is then adjusted hourly by 20-25% based on the target urinary output of 30-50mL. (A higher target of 50-70mL is used for electrical injuries.) The Modified Brooks Formula is also readily used in burn patients. If you really want to get into the weeds, look up "Ivy Index" on why we would consider these alternative formulas.
Thanks for sharing! Not a ton of first hand experience managing burns. I appreciate the info and places to learn more. Thanks Stephanie!
Very great video. Now I understand the fluid maintenance calculation. The only mistake you did is when using 100:50:20 rule for a patient weighs 75kg the fluid needed for a day is 2600 ml and not 2700 ml. thanks again for your marvelous video
Correct and that changes the fluid per hour to 108 ml.
Thank you so much for video. So easy to understand.
Hi! Great channel. Could you do a video on different types of anticoagulants and it’s effect (ie Warfarin and Vit K)
JUST NOW I'M ATTEMPT QUIZ CALCULATIONS OF FLUIDS
GOT 80% PASSED
you don't have idea how this video saved my day
Oh wow! I'm genuinely curious now!
Thank you for the refresher
You're welcome
Thank you!! Helps a lot!!
Exceptional work. Thank you
This is so good!!! Love the explanation and keep doing what you do!
That was a great video. I definitely understand it a lot better than I did before. Much appreciated!
Great to hear this! Appreciate that!
Thank you so much for your information ❤🥰
Thank you so much for another great video))
(Sorry, but it’ll be 2600, not 2700, - time 11:25)
Thank you! And haha yup! Apparently I failed at simple math that day!🤦
@@ICUAdvantage that happens 😄
We got to the core idea, thankyou for that ❤️
Thankyou so much for it.
I have started my residency in Anesthesia, ev one was talking about this 4:2:1 rule, as i watch your videos regularly i was expecting that you might have covered this topic, & here it goes 🙌🏻
Thankyou for the great work 🙌🏻
I noticed this to!🤗
You are my new Professor 🌟!!!!!!
Thank you so much! This series has been really helpful. I have never really understood fluids before this
Awesome! Really glad it is helpful for you.
Thanks so much for awesome videos and information! I’ve been waiting for this Fluid/electrolyte series from you, and I knew it would be great! Question: I work in Peds, but we do have adult size patients/or heavy patients, and we typically cap their Maintenance Fluids at 100-120ml/h, even if the 4/2/1 calculation suggests more than that. Is there a cap for adults? I know you mentioned we can use their IBW, but I’m just curious if there’s a cap when they reach a certain weight. Thanks!!
Appreciated…very nicely and easily explained
Thank you!
Thankyou so much ❤
You're very welcome! :)
Thank you
100 50 20 can be used in paediatrics as well
thank you this really helped me
Glad it helped!
Great video dr. Can you add some bibliographic referentes Sherlock i could read?
Talking about fluid manage ment in burn
Please I need more videos it was interesting
this was so wholesome thanks!
Glad you liked it!
Thanks
You're welcome.
thank you
You're welcome
Many thanks dr
Thank you, although not a doc 😊
How to calculate the bolus fluid?
Thanks alot
Thank You for doing this video.🌟🌟
Absolutely my pleasure!
Thanks for sharing. I have a question. According to the regimen, do you worry about the vasculitis due to high osmolality of using D5S only? In our hospital, we usually use 5%dextrose+1/2normal saline. What's your opinion? Thank you very much.
I personally have not seen any issues with it.
Great. Video hw abt how to calculate drips?
Let me think about that one and possibly add it to the todo list.
Thanks very informative.
Glad to hear it Marietta!
Great channel. THANK YOU!!!!
Wow, thank you so much Susan! 😊 Happy to be able to help!
@@ICUAdvantage I’m a nurse at the ICU since 8 months now and your channel helps me a lot! 😍
@@Susan__g so awesome! Congrats on the new ICU position by the way. How exciting. It really means to world to me that these lessons are helpful for you and others. I really appreciate you taking the time to let me know. ❤️ I’m always happy to help when I can. Feel free to send any questions or even just updates on how things are going. You can find my email on the main UA-cam page about section. Wish you all the best! 😊
@@ICUAdvantage thank you so much! I really appreciate it 😍
How do we calculate Bolus doses in cases of shock or hypovolemia ?
HI! Thank you for this easy to understand video :) but can I ask if this calculations also apply to Dengue patients? Thanks!
Thanks it was so helpful
Glad to hear!
Thanks a lot!
You're welcome!
Nice class thank you sir i am from india.( U.P)
Very cool! Glad you liked it!
@@ICUAdvantage thank you changing the language in hindi vidio lecture please sir 😃
@@ICUAdvantage where du you live
@@dr.alok.gangwar3268 I’m in the US
So useful, plz keep on 👍🏻👍🏻👍🏻
Awesome and I def will!
Can you do a full head to toe assessment, and how to write end of shift nurse progress notes
I'll add to the todo list!
how do you know when to switch from dextrose to normal saline?
Thanks..
You're welcome!
Changing iv fluid to n/s when there is nutrition y mean NGT feeding right ? or what
What software do you use to makes this vids?
As someone aspiring for ICU this channel is really great to listen to to re-inforce and learn on key points. Thank you!
Quick question, how do you typically calculate ideal body weight for a bedbound patient in ICU?
Awesome to hear David! Thanks for being a part of the channel!
And good question. It depends which formula you use, but essentially you take whether they are male or female and use their height. Its then a simple calculation (or lookup table) to determine what the IBW is.
@@ICUAdvantage Thanks a heap for getting back to me. Is this is typically done with a simple measuring tape?
@@TeacupSO Yeah if you couldn't get it from them or family. That would work. Or estimation in a moments need.
Have not grasped the concept yet as i am not at this calculations.
Beauty of the videos here is you can always go back and rewatch whenever needed :)
For the 75 kg pt could we also do: 10x 4 = 40
20 x 2 = 40
45 x 1 = 45
Total: 125 ml/hr
Even if maintenance rate is different?
Have you found any answers? It's my question too.
You are the man
Haha thanks Jacob!
Hmm, in my unit (cardiac and renal) we normally just give 0.5ml/ph per kg
I'll have to ask the docs
Remember certain populations will have limits or specific needs. Cardiac populations are ones that we want to be very conservative with fluids, so that makes complete sense
How come Eddie sounds soooooo Dreamy?!?
Haha, maybe too much wine?!? 😂😂😂 j/k, but glad someone likes the voice. I certainly am not a fan! lol
@@ICUAdvantage No EtOH on board when I said that bro. lol. Genuine comment 😁We're our own toughest critics, I don't like hearing myself either
Comment for youtube algorithm :)
Calculations don't start until 6:45
Adding 40 to the weight in kg works for anyone 20kg and over.
Yup!
the sound is not good I am quite disappointed
What do you mean? I haven't had anyone else say anything...
This font is not appropriate for this video. Not read properly
My handwriting?
@@ICUAdvantage writing should wide and clear . Content is good . I can't read properly.
Thank you