SCCM Resource Library-Strategies for IV Fluid Conservation in the ICU

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The document is a tip sheet on strategies to conserve intravenous (IV) fluids in intensive care units (ICUs), developed by various healthcare professionals but not endorsed by the Society of Critical Care Medicine. It outlines several strategies aimed at optimizing the use of IV fluids:<br /><br />1. <strong>Promote Oral Hydration</strong>: Encourage oral hydration when clinically appropriate to decrease dependence on IV fluids. Reduce nothing-by-mouth periods in suitable scenarios, such as perioperative settings.<br /><br />2. <strong>Validate Necessity and Fluid Responsiveness</strong>: Ensure the clinical need for IV fluid administration through validated approaches like dynamic measurements or point-of-care ultrasound.<br /><br />3. <strong>Consider Fluid-Restrictive Strategies</strong>: After initial resuscitation, use fluid-restrictive strategies for certain patients instead of liberal fluid administration.<br /><br />4. <strong>Avoid Waste</strong>: Use smaller bags for low-rate infusions and complete a current solution before switching to a new one to minimize waste.<br /><br />5. <strong>Optimize Fluid Management Protocols</strong>: Modify electronic health records to include regular reassessment of IV fluids and consider automatic stop times for maintenance solutions.<br /><br />6. <strong>Enhance Communication</strong>: Improve communication between prescribers and nurses to confirm the continued necessity of IV fluids before starting new infusions.<br /><br />7. <strong>Use Just-in-Time Preparation</strong>: Prepare fluid infusions as needed rather than in advance to prevent waste.<br /><br />8. <strong>Evaluate KVO Practices</strong>: Assess the necessity of keep-vein-open (KVO) orders and adjust rates to the lowest required.<br /><br />9. <strong>Use Push-Dose Medications</strong>: When suitable, use push-dose medications to save IV fluids, while considering the implications on therapeutic goals.<br /><br />10. <strong>Use Oral Medications When Possible</strong>: Opt for oral medications and electrolyte replacements unless gastrointestinal absorption is compromised.<br /><br />11. <strong>Centralize IV Fluid Stock</strong>: Centralize IV fluid inventories to ensure efficient use and distribution, and have plans in place for addressing shortages.<br /><br />12. <strong>Prioritize Critical Care</strong>: Reserve crystalloids for emergency situations and major surgeries, ensuring they're not withheld from those who would benefit. <br /><br />These strategies aim to efficiently manage IV fluid resources, reduce waste, and maintain effective patient care.

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Crisis Management, 2024

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English and Spanish

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Content Type Infographic

Knowledge Area Crisis Management

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Membership Level Associate

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Year 2024

Keywords

IV fluid conservation

intensive care units

oral hydration

fluid responsiveness

fluid-restrictive strategies

reduce waste

fluid management protocols

communication in healthcare

just-in-time preparation

centralize IV stock

Infographic

Crisis Management

Resource Allocation

2024

Nonmember

Associate

Professional

Select

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