Call Sanlian (Lobelin, Huisuling, Kelamin)

Old triple needle: epinephrine, norepinephrine, isoproterenol

New triple needle: epinephrine, atropine and lidocaine

(But after consulting relevant information, some said that Su Ling had been eliminated.)

Adrenaline:

\ alias accessory renal base; Adrenaline hydrochloride

Mbth Adrenaline

Pharmacological action and use

Stimulating β receptors in myocardium, conduction system and sinus node can enhance myocardial contractility, increase cardiac output, accelerate conduction and increase heart rate. Activation of β2 receptors in skin mucosa and visceral vessels, especially renal artery contraction, skeletal muscle and coronary artery expansion. Stimulate bronchial β2 receptor and dilate bronchi. It acts on β2 receptor of liver and fat, promotes the decomposition of liver glycogen and fat, and raises blood sugar. It can be used for the rescue of cardiac arrest and anaphylactic shock, and also for the treatment of other allergic diseases (such as bronchial asthma and urticaria). Combined with local anesthetics, it is beneficial to local hemostasis and prolong drug effect.

Indications to rescue anaphylactic shock; Rescue cardiac arrest; Treating bronchial asthma; Stop bleeding of nasal mucosa and gums.

Dosage usage

1. It is often used to rescue anaphylactic shock, such as anaphylactic shock caused by penicillin. Because this product has the functions of exciting myocardium, raising blood pressure and relaxing bronchial smooth muscle, it can relieve the symptoms of anaphylactic shock such as weak heartbeat, decreased blood pressure and dyspnea. Subcutaneous injection or intramuscular injection of 0.5 ~ 1 mg can also be used for slow intravenous injection of 0.1 ~ 0.5 mg (diluted to 10 ml with isotonic saline). If the curative effect is not good, 4 ~ 8 mg can be used for intravenous drip (dissolved in 500 ~ 1000 ml of 5% glucose solution). 2. Rescue cardiac arrest; It can be used for cardiac arrest caused by accidents during anesthesia and surgery, drug poisoning or cardiac conduction block, etc., with 0.25 ~ 0.5 mg intracardiac injection, cardiac massage, artificial respiration and correction of acidosis at the same time. For cardiac arrest caused by electric shock, this product can also be used to rescue with electric defibrillator or lidocaine. 3. Treatment of bronchial asthma: the effect is quick but not lasting. Subcutaneous injection of 0.25 ~ 0.5 mg can take effect in 3 ~ 5 minutes, but it can only last for 1 hour. Repeat the injection once if necessary. 4. Combined with local anesthetics: adding a small amount (about 1: 200,000 ~ 500,000) to local anesthetics (such as procaine) can reduce the absorption of local anesthetics, prolong their efficacy, reduce their toxic and side effects, and also reduce bleeding at the surgical site. 5. Stop the bleeding of nasal mucosa and gums: Fill the bleeding place with gauze soaked with (1: 20,000 ~ 1: 1000) solution. 6. Treatment of urticaria, hay fever, serum reaction, etc.: subcutaneous injection of 0.2 ~ 0.5 ml of 1: 1000 solution, and injection of the above dose once if necessary.

matters need attention

1. Hypertension, heart disease, diabetes, hyperthyroidism, digitalis poisoning, traumatic and hemorrhagic shock and cardiac asthma are contraindicated. 2. Excessive dosage or mistaken entry into blood vessels during subcutaneous injection can cause a sudden increase in blood pressure and lead to cerebral hemorrhage. 3. The common side effects are palpitation and headache, which can sometimes cause arrhythmia, and in severe cases can cause death due to ventricular fibrillation. 4. Do not use local anesthesia more than 300μ g each time, otherwise it may cause palpitation, headache and high blood pressure. 5. Before using this product to resist shock, first replenish blood volume and correct acidosis.

specifications

1. injection: it is a sterile solution of epinephrine hydrochloride or epinephrine tartrate, and each ml contains 1 mg of epinephrine and 8 mg of sodium chloride.

Atropine:

Atropine sulfate

Pharmacologically, it is an anticholinergic drug that blocks M-choline receptor and can relieve the spasm of smooth muscle (including relieving vasospasm and improving microvascular circulation); Inhibit gland secretion; Relieve the inhibition of vagus nerve on the heart and accelerate the heartbeat; Dilate the pupil and increase the intraocular pressure; Excite the respiratory center.

Pharmacokinetics This product is easily absorbed from gastrointestinal tract and other mucous membranes, and can also be absorbed from eyes or a small amount from skin. After oral administration of 1h, the peak effect t 1/2 is 3.7 ~ 4.3h.. The binding rate of plasma protein is14% ~ 22%, and the distribution volume is1.7l/kg, which can be quickly distributed in the whole body, and can pass through the blood-brain barrier and placenta. Half of a dose is metabolized by the liver, and the other half is excreted by the kidney in its original form. Trace amounts are found in various secretions including milk.

Indications are mainly used in clinic: (1) rescuing toxic shock caused by infection: adult 1 ~ 2 mg each time, child 0.03 ~ 0.05 mg/kg, intravenous injection, every15 ~ 30 minutes/time, after 2 ~ 3 times. (2) Treatment of Asperger's syndrome caused by antimony: When serious arrhythmia is found, immediately inject1~ 2 mg intravenously (diluted with 5% ~ 25% glucose solution10 ~ 20 ml) and inject 1mg intramuscularly or subcutaneously at the same time. If the patient has no seizures, it can be changed to subcutaneous injection or intramuscular injection 1mg every 3 ~ 4 hours according to the heart rhythm and heart rate. If there is no seizure after 48 hours, it can be gradually reduced and finally stopped. (3) Treatment of organophosphorus pesticide poisoning: ① When combined with pralidoxime, for moderate poisoning, subcutaneous injection of 0.5 ~ 1 mg every time, every 30 ~ 60 minutes1time; For severe poisoning, intravenous injection of1~ 2 mg every time, once every15 ~ 30 minutes, until the condition is stable, gradually reduce the amount and switch to intradermal injection. ② Single use: For mild poisoning, subcutaneous injection of 0.5 ~ 1 mg every time, every 30 ~120 minutes/time; For moderate poisoning, subcutaneous injection of 1 ~ 2 mg every time, every15 ~ 30 minutes1time; For severe poisoning, give 2 ~ 5 mg intravenously immediately, and then every time 1 ~ 2～5mg, every15 ~ 30 minutes1time, and gradually reduce and extend the interval according to the condition. (4) Relieving visceral colic: including pain caused by gastrointestinal spasm, renal colic, biliary colic, gastric and duodenal ulcer, with subcutaneous injection of 0.5mg each time. (5) For administration before anesthesia: subcutaneous injection of 0.5mg can reduce the secretion of bronchial mucus during anesthesia, prevent postoperative pneumonia, and eliminate the respiratory inhibition of morphine. (6) Used in ophthalmology: it can dilate pupils and regulate paralysis, and is used for keratitis and iridocyclitis. With1%~ 3% eye drops or eye ointment. When dripping, press the inner canthus to prevent it from flowing into the nasal cavity and being absorbed and poisoned.

Precautions (1) are often dry mouth and dizziness, and in severe cases, pupils are dilated, skin is flushed, heart rate is accelerated, excitement, irritability, delirium and convulsions. (2) Patients with glaucoma and prostatic hypertrophy are prohibited. (3) In general, the oral dosage is extremely high, 1 time 1mg, 1 day 3 mg; Subcutaneous or intravenous injection, 1 time 2mg. When used for organophosphorus poisoning and Asperger's syndrome, the dosage can be determined according to the condition.

Poisoning occurs when the dosage of poisoning rescue exceeds 5mg, but few people die, because the toxic dose (5 ~10 mg) is far from the lethal dose (80 ~130 mg). Emergency oral atropine poisoning patients can gastric lavage, catharsis, in order to remove unabsorbed atropine. Short-acting barbiturates or chloral hydrate can be used when the excitement is too strong. Use nikethamide for respiratory depression. In addition, neostigmine can be injected subcutaneously for 0.5 ~ 1 mg every 15 minutes1time until the pupils are narrowed and the symptoms are relieved.

Specification tablets: 0.3mg per tablet. Injection: 0.5 mg each (1ml); 1mg(2ml); 5mg( 1ml)。 Eye drops: atropine sulfate 1g, sodium chloride 0.29g, anhydrous sodium dihydrogen phosphate 0.4g, anhydrous disodium hydrogen phosphate 0.47g, hydroxyethyl acrylate 0.03g, and distilled water added to 100ml.

Lidocaine:

Alias serocaine; Silocaine, lidocaine

Mbth Lidocaine, Xylocaine

indication

Local anesthesia is stronger than procaine, and its duration is twice as long as procaine, but its toxicity is correspondingly increased. 1. Used for block anesthesia and epidural anesthesia. 2. Used for ventricular tachycardia and frequent ventricular premature beats.

Dosage usage

1. local anesthesia: 1% ~ 2% solution should be used for block anesthesia, and the dosage should not exceed 0.4g each time. Generally, topical anesthesia is applied with 1% ~ 2% solution, sprayed or dipped in medicine, and the total amount at one time does not exceed 0.25 g. 0.25% ~ 0.5% solution is used for infiltration anesthesia, and the dosage per hour is not more than 0.4g.. Epidural anesthesia with 1% ~ 2% solution, each dose is not more than 0.5g.. 0.5% solution can be used to block anesthesia, and 1% solution can be used near nerve trunk, which is better than procaine. 2. Treatment of arrhythmia: intravenous injection of 1 ~ 3 mg per kilogram of body weight each time, the injection speed can be faster. If it is ineffective, the same amount can be injected once again in 10 ~ 15 minutes, and at the same time, 100 mg can be taken and added to 100 ~ 200 ml of 5% ~ 10% glucose solution for intravenous drip. The total amount of one treatment is 4 ~ 6 mg per kilogram of body weight.

matters need attention

1. The toxicity of lidocaine is about 1 ~ 2 times that of Proca. If absorbed quickly and in large quantities, it often causes convulsions; However, some patients have depression rather than excitement in the central nervous system. The systemic reaction is the same as that of Proca. 2. During intravenous injection, there may be anesthesia-like feeling, dizziness and black eyes. If the medicine is dropped intravenously, this symptom can be alleviated. 3. Patients with heart and liver dysfunction should be reduced appropriately. 4. Second-and third-degree atrioventricular block, allergic to this product, grand mal's history, severe liver dysfunction and shock patients are prohibited.

Specification injection: 0.2g (10ml) and 0.4g (20ml) each.

Lobelin:

Alias Lobelin; Garcinine hydrochloride

Mbth Lobeline, Lobeline Hydrochloride, Inlatine, Lorbon, Racemic, Unilobin.

indication

It can be used for neonatal asphyxia, asphyxia caused by carbon monoxide, poisoning caused by inhaling anesthetics and other central depressants (such as opioids and barbiturates), and respiratory failure caused by infectious diseases such as pneumonia and diphtheria.

Dosage usage

Subcutaneous injection and intramuscular injection of 3 ~ 10 mg once for adults (20 mg once, 50 mg once a day, 1 ~ 3 mg once for children). Intravenous injection of 3 mg for adults once, with a maximum of 20 mg per day; 0.3 ~ 3 mg once for children. It can be repeated once every 30 minutes if necessary.

Precautions: the static note should be slow; Large doses can cause tachycardia, conduction block, respiratory depression and even convulsions.

Specification injection: 3 mg (1 ml) each; 5mg( 1ml); １０ｍｇ（１ｍｌ）; 20mg( 1ml)。

Coramine:

Alias diethylamine hydrochloride; Coramine; Ethylamine hydrochloride, nikethamide

Nikethamide ,Coramine, mbth

Indications: First aid for poisoning caused by central respiratory and circulatory failure, anesthetics and other central depressants.

Dosage and usage: subcutaneous injection, intravenous injection or intramuscular injection, 0.25 ~ 0.5g each time.

Precautions: Large doses can cause high blood pressure, palpitation, sweating, vomiting, tremor and muscle rigidity, so stop taking drugs in time to prevent convulsions. Oral and injection absorption is good.

Specification injection: 0.375g (1.5ml) each; 0.50ｇ（２ｍｌ）。

Back to Su Ling:

Alias Hui Su Ling, Dimethyl Flynn

Mbth Dimefline ,Remefline, Rec7076

Indications: central respiratory failure caused by various reasons, respiratory depression caused by anesthetics and hypnotics, and collapse and shock caused by trauma and surgery.

Dosage usage

1. intramuscular injection: 8 mg each time. 2. Intravenous injection: 8 mg each time, diluted and mixed with glucose solution, and then slowly injected. Severe patients can use up to 16 ~ 32 mg. The intravenous drip is diluted with isotonic sodium chloride solution or glucose solution for injection.

matters need attention

1. Nausea, vomiting, burning skin, etc. Excessive dosage can cause muscle tremor and convulsion. 2. Short-acting barbiturates (such as pentobarbital) should be prepared for first aid in convulsions. 3. The intravenous injection speed must be slow, and we should always pay attention to the change of the condition. 4. People with a history of convulsions, liver and renal insufficiency and pregnant women are prohibited.

Specification injection: 8 mg (2 ml) per injection.

First, remember several important formulas:

(1) 5% nahco3 (ml) = (22–measured HCO3ˉ)* 0.5* 1.7* body weight (kg) (0.6 in some cases).

= (22–measured HCO3ˉ)* body weight (kg )(5%SB 1ml=0.6mmol)

The number of mmol of alkali supplement =(-BE)*0.3*W(kg), that is, 5%SB(ml)=(-BE)*0.5*W(kg).

Give the amount of 1/2 first.

Estimation method: 5 ml/kg * times of 5% Sb OR. 1 1.2% sodium lactate 3ml/kg is calculated according to the increase of plasma HCO3ˉ5mmol/L temporarily.

⑵25% arginine hydrochloride (mL) = [(measured HCO3 ˉ-27) mmol/L] * 0.5 * 0.84 * W (kg).

⑶ Potassium supplement amount (mmol)=(4- measured blood potassium) * body weight (kg) * 0.6 (1mmol k = 0.8 ml inj.10% KCl).

(4) Sodium supplementation amount (mmol)=( 140- measured blood sodium) * body weight (kg)*0.6 (0.5 for females)

5] the amount of water needed (ml)= (measured blood sodium value-140)* body weight *4(kg)

⑹

Second, the need to pay attention to and remember the problem

1, calculated total rehydration: mild dehydration: 90- 120ml/kg; Moderate dehydration: 120- 150ml/kg; Hypertonic dehydration: 150- 180ml/kg.

2. Replenish the cumulative loss of hypotonic dehydration: use 2/3 sheets of 4: 3: 2 solution (4 parts of salt, 3 parts of sugar and 2 parts of alkali).

3. Replenish the cumulative loss of isotonic dehydration, various dehydration losses and physiological requirements: use 1/2 sheets of 3: 2: 1 liquid (3 parts of sugar: 2 parts of salt:1part of alkali).

4, remember-salt: alkali is always 2:1(here, "alkali" means 1.4%SB) so as to be close to the ratio of sodium to chlorine in plasma, so as to avoid excessive infusion and high blood chlorine. Sugar is 5%- 10% GS, salt is NS(0.9%NaCl), and alkali is 5%NaHCO3 (diluted as 1.4%NaHCO3 method: divide 5% alkali by 4, and make up the rest with sugar. For example:100 ml of 5% alkali is diluted to 1.4% alkali: 100/4=25, 100-25=75, that is, 25ml5% of 5% alkali +75ml of sugar).

5. Potassium supplementation: The total amount of 10%KCl per 100ml of liquid shall not exceed 3ml, so that the potassium concentration shall be less than three thousandths.

6. Capacity expansion: 2: 1 equal volume of sodium-containing solution (2 parts of salt:1part of alkali) is calculated as 20ml/kg, and it will be dripped within 30 minutes.

7. The cumulative loss is made up in the first 8 hours, which is 1/2.

Third, the basic principles of liquid therapy

"One, two, three, four"

A plan, a 24-hour plan

Two steps to supplement the accumulated loss and maintain fluid replacement.

Three steps to determine quantity, quality, speed and speed.

Four words: fast first, then slow, salt first, then sugar,

See urine potassium supplement, adjust at any time.

Three-fixed principle "one" fixed fluid supplement

30-50ml/kg lighter

Cumulative loss is 50- 100 ml/kg in dehydration degree.

Weight 100- 120ml/kg

How much do you lose if you continue to lose

How much diarrhea 10-40ml/kg/d?

Physiological requirement basal metabolism 60-80ml/kg/day.

The principle of "three definitions" determines the properties of liquid.

Isotonic: 2 :3: 1 solution (1/2 sheets)

Cumulative loss, dehydration and low permeability: 4 :3 :2 solution (2/3 sheets)

Hypertonic solution: 2 :6: 1 solution (1/3 sheets)

Continue to lose what?

What diarrhea 1/3- 1/2 sheets?

Physiological requirement physiological requirement 1/4- 1/5 solutions

Three principles "three" determine the speed and steps of rehydration.

One step: replenish the accumulated loss within 8- 12 hours, 8-10 ml/kg/h.

Mild and moderate dehydration is divided into two steps.

Step 2: Maintain fluid replacement (continuous loss+physiological requirement)

12- 16 hours, 5ml/kg/h

(degree of dehydration)

Step 1: capacity expansion stage 2: 1 isotonic sodium solution or 1.4% sodium carbonate solution 20ml/kg (total amount < ＜300ml) for 30-60min.

Hypertonic dehydration drips in three steps.

Step 2: The cumulative loss should be supplemented by subtracting the capacity expansion, and the rest is the same as above.

Three steps: maintain fluid infusion as above.

Electrolyte supplement 1, sodium 2, potassium 3, calcium

Correct acid-base balance disorder

Alkaline supplement to correct acidosis

1, calculated according to the formula

2. Calculated by increasing Co2CP by 5 mmol/L.

Four, familiar with the types, components and preparation of commonly used liquids.

Water for injection is forbidden to be directly infused by vein, because it has no osmotic tension, and infusion by vein can make RBC swell and rupture, causing acute hemolysis.

(1) Non-electrolyte solution: commonly used are 5% GS and10% GS, which mainly supply water (evaporated by breathing, skin (and lost by urination) and supply part of heat, and can correct the hypertonic state of body fluids, but it cannot be used to supplement the loss of body fluids. 5% GS is an isotonic solution, and10% GS is a hypertonic solution. However, glucose is oxidized into carbon dioxide and water shortly after it is injected into the body, and energy is supplied at the same time, or it is converted into glycogen and stored in liver and muscle cells, which does not play a role in maintaining plasma osmotic pressure. (Note: 1 0% GS supplies more heat than 5%GS, although its osmotic pressure is higher than 5% GS1times. If it is slowly dripped through vein, Glucose will be rapidly diluted by blood and metabolized, and its effect is basically similar to that of 5% GS. Glucose input speed should be kept at 0.5-0.85g/kg*h, that is, 8- 14mg/kg*min. )

(2) Electrolyte solutions: There are many kinds, which are mainly used to replenish lost liquids (loss of body fluids) and electrolytes and correct the imbalance between acid and alkali, but they cannot be used to replenish water that is not necessarily lost and is needed for diluting urine.

1) physiological saline (0.9% sodium chloride solution): It is an isotonic solution, which is often used after being mixed with other liquids. Its sodium and chlorine contents are 154mmol/L, which is very close to the plasma concentration 142mmol/L, while the chlorine ratio is (103 Excessive input can make blood chlorine too high, especially in severe dehydration acidosis or poor renal function, which may aggravate acidosis. Therefore, 2 parts of normal saline and 1 kloc-0/.4% nahco 3 are often mixed in clinic, so that the ratio of sodium to chlorine is 3: 2, which is similar to that in plasma.

2) Hypertonic sodium chloride solution: commonly used are 3% NaCl and10% NaCl, both of which are high-concentration electrolyte solutions. 3% NaCl is mainly used to correct hyponatremia, and10% NaCl is mostly used to prepare various mixed solutions.

3) Sodium bicarbonate solution: it can directly increase buffer alkali and correct acidosis quickly, so it is the first choice for the treatment of metabolic acidosis.1.4% solution is isotonic solution and 5% is hypertonic solution. In the emergency rescue of acidosis, intravenous injection can also be given without dilution. However, the osmotic pressure of extracellular fluid can be increased after repeated use.

4) Potassium chloride solution:10% potassium chloride solution and15% potassium chloride solution are commonly used. None of them can be used directly, and they must be diluted into 0.2% ~ 0.3% solution for intravenous drip. Potassium-containing solution cannot be injected intravenously, and if the injection speed is too fast, myocardial inhibition may occur and death may occur.

(3) Mixed solution: In order to meet the needs of different clinical situations, several solutions are prepared into different mixed solutions according to a certain proportion to complement their shortcomings. For the composition and preparation of common mixed solutions, see the following simple preparation of common mixed solutions:

Simple preparation of several mixed liquids (ml)

Solution type 5% (10%) GS10% NaCl 5% sb.

1: 1 liquid 500 20

1:4 liquid 500 10

2: 1 liquid 500 30 47

2.6:1liquid 500 10 16

2.3:1liquid 500 15 25

4:3:2 Liquid 500 20 33

Note: In order to make the preparation simple, all the liquids added are integers, and the approximate liquid is prepared.

2.6:1liquid 500 10 16

2.3:1liquid 500 15 25

4:3:2 Liquid 500 20 33

2.6:1liquid 100 2 3

2.3:1liquid 100 3 5

4:3:2 liquid 100 4 7

5%SB tension of liquid G S salt

2∶3∶ 1 100 3 5 1/2

4∶3∶2 100 4 6 2/3

2∶ 1 100 7 9 equal sheets

1∶ 1 100 5 1/2

1∶4 100 2 1/5

1/3 sheets of liquid 100 3 1/3

1/4 sheets of liquid 100 2.5 1/4

Composition and application of mixed liquid

5%GS 0.9%NaCl 1.4%SB Osmotic Pressure Application

2: 1 sodium solution 2 1 isotonic hypertonic dehydration expansion acid.

2.3:1solution 3 2 1 1/2 isotonic dehydration

4:3:2 solution 3 4 2 2/3 hypotonic dehydration

2.6:1solution 6 2 1 1/3 hypertonic dehydration

(Examples of mixed liquid preparation are handwritten)

1:1liquid refers to NS and GS1serving, which is 1/2 sheets of liquid, and is used for vomiting and dehydration without obvious alkalosis and acidosis.

1:4 liquid refers to NS 1 serving and GS 4 serving, which is 1/5 sheets of liquid, and is used to supplement physiological requirements.

[For example, a child, male, 1 year old, with normal development, was diagnosed with autumn diarrhea. PE: sunken eyes, dry skin, no tears when crying, and low pulse rate in urine. According to the medical history, sunken eyes, skin elasticity, circulation, urine volume (pre-training) and other indicators, it is judged as severe hypotonic dehydration. 1 year-old estimated normal development weight 10kg

Total infusion volume:180 *10 =1800 ml, in which the expansion capacity is 20* 10=200ml, and the cumulative loss 1800/2-200=700 (supplement/kloc)

Infusion step: in the first step, the volume of 210/3 = 70ml, 70 * 2 =140ml of salt and 70ml of alkali (1.4%NaHCO3) is equivalent to 70/4 =17.5ml of 5% nahco3.

In the second step, the cumulative loss is 700ml of 4: 3: 2 solution, 700/9=77.7-80, 80*4=320ml of salt, 80*3=240 sugar, 80*2= 160 alkali (1.4%NaHCO3.

The third step is to make up the loss and physiological requirement1800-210-700 = 890-900 ml of 3: 2:1liquid, 900/6= 150,150. 150ml alkali (1.4%NaHCO3) is equivalent to 150/4=37.5ml 5%NaHCO3 and150-37.5 =1/2.5ml.

The fourth step is to supplement potassium in urine: 10%KCl 15ml.

Five, the purpose of children's fluid infusion

1 Adjust the amount of liquid in the circulation system

Physiological requirement, cumulative loss, extra loss

2 correct electrolyte acid-base balance disorder PH,K+,Na+ ,Clˉ,Ca2+, HCO3ˉ.

colloid osmotic pressure

[Purpose of intravenous infusion] The purpose of liquid therapy is to correct the existing water and electrolyte disorders in the body, restore and maintain the stability of blood volume, osmotic pressure, acid-base balance and electrolyte components, and make the body perform normal physiological functions.

[Key]

First, the amount of liquid:

Influencing factors: repair, growth and development;

Postoperative hypoproteinemia;

Strong metabolism and high water demand;

Every increase in body temperature10c-increase in liquid volume 10%.

Daily demand:10kg10kg10kg.

100ml 50ml 20ml

Every 100ml liquid:10% glucose 80ml 0.9% n.s 20ml10% KCl1.5ml.

The amount of fluid on the day after operation is 70% of the required amount, which should include hemostasis, anti-infection and vitamins.

If potassium is low during operation or after operation, potassium can be supplemented immediately, otherwise, potassium supplementation will generally start on the first day after operation (people who are forbidden to eat or drink).

Complement on the first day after operation

Cumulative loss: dehydration degree is related to dehydration property.

Such as: mild to moderate severity

5% body weight 5- 10 10- 15

Newborns' blood H+ Cl- Na+ K+ P is high and HCO 3 is low, and K+ tends to be normal after 7 days. So:

/kloc-fluid replacement is not required within 0/24 hours, except for surgical diseases.

The metabolism was low within 2 3 days, and the fluid replacement was 60- 100ml/kg.

After 3 7 days, the rehydration fluid can be increased to 100- 120ml/kg.

NaHCO3 and K+ can be supplemented if Na+ Cl- is not supplemented within 4 days, and K+can not be supplemented within 7 days.

Electrolyte will not be replenished within 5 1-2 days.

2. Energy: 0-1year 100kcal/kg, and the energy requirement decreases with each increase of three years 10kcal/kg.

Third, the electrolyte

1. Isoosmotic sodium content that should be supplemented = (normal value-measured value) * weight *4

Generally speaking, only half the amount is added at first, and then it will be added as appropriate.

2. The amount of isotonic potassium-containing liquid that should be supplemented when potassium is low = (normal value-measured value) * weight *0.6.

Generally speaking, only half the amount is added at first, and then it will be added as appropriate.

3. 10% calcium gluconate 0.3ml/kg*d

After blood transfusion, calcium should be supplemented routinely 10% calcium gluconate 1ml/ 100ml blood.

4. 25% magnesium sulfate 0.2-0.4ml/kg* times (4- 10ml/ time for adults) 1-2 times/week is diluted with 5% or. 10%GS and then slowly dripped.

IV. Infusion speed

Infant 7-9ml/kg*h(2gtt/min)

Heart failure <: 6ml/kg*h

Shock is about18-20ml/kg * h.

Composition, infusion speed

For severe or moderate dehydration with poor peripheral circulation, isotonic 2: 1 solution (2 portions of 0.9% sodium chloride:1portion 1.4% sodium bicarbonate or 1/6M sodium lactate) of 20 ml /kg was used for 30min to/kloc-0. After capacity expansion, different liquids 80 ~100 ml/kg were used according to the dehydration properties, and intravenous infusion was continued to correct the accumulated loss. Isoosmotic and hypotonic dehydration, the speed can be faster at 8 ~10 ml/kg * h, generally 8 ~12 h to make up the accumulated loss. Hypertonic dehydration needs to be slower, and the accumulated loss should be replenished in 48 hours to prevent brain water from appearing too quickly during rehydration.