Risks of intravenous administration of hypotonic fluids for pediatric patients in ED and prehospital settings: let's remove the handle from the pump.
Fluid resuscitation of infants and children is a common management problem in prehospital and emergency department care. We present two cases of children who received 5% dextrose in water as the initial resuscitation fluid. Bolus administration of hypotonic fluid contributed to fatal outcomes in these cases. Recommendations are made for eliminating hypotonic fluids as stock items in both the prehospital and emergency department settings.
Jackson
J
J
Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, USA.
Bolte
R G
RG
D001929:Brain Edema / Q000139:chemically induced; D002675:Child, Preschool; D003681:Dehydration / Q000097:blood / Q000209:etiology / Q000628:therapy*; D004632:Emergency Medical Services / Q000379:methods; D004830:Epilepsy, Tonic-Clonic / Q000139:chemically induced; D017809:Fatal Outcome; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects*; D005947:Glucose / Q000009:adverse effects*; D006801:Humans; D007010:Hyponatremia / Q000097:blood / Q000139:chemically induced; D007038:Hypotonic Solutions / Q000009:adverse effects*; D007223:Infant; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D017410:Practice Guidelines as Topic; D012151:Resuscitation / Q000009:adverse effects*; D012769:Shock / Q000097:blood / Q000209:etiology / Q000628:therapy*
D007038:Hypotonic Solutions; D005947:Glucose