HIGHER DEXTROSE CONCENTRATION SOLUTION PREPARATION
May 12 2014 ADD THE VOLUME OF 50% DEXTROSE TO THE VOLUME OF 10% DEXTROSE TO MAKE UP A TOTAL OF 100 ML. DESIRED DEXTROSE CONC. VOLUME OF 10% DEXTROSE.
Fluid Management
Page 10. How to make a dextrose solution. To make a fluid with 10% dextrose. • Dilute at a ratio of 1:4. • For example take 200 ml 50% dextrose and add to 800
Making up intravenous fluids
0.45% Sodium Chloride 10% glucose 500ml bag. Method 1: If 0.45% Sodium Chloride with 5% dextrose is available a) Remove and discard 56 ml from a 500ml bag of
ANNEXURE
dextrose to make a total of 100 mL. For example to prepare 100ml of 10% dextrose from 5% dextrose and 25% dextrose
Quick Concentrations Cheat Sheet (Using 50% Dextrose)
To make a 2.5% dextrose solution. Add 50 cc to 1000 mL. Add 25 cc to 500 mL. Add 12.5 cc to 250 mL. To make a 5% dextrose solution. Add 100 cc to 1000 mL.
Chart 10. How to give glucose intravenously
– IV fluids containing 5–10% glucose (dextrose) (see Annex 4 p. 377). Note: 50% glucose solution is the same as 50% dextrose solution. If only 50% glucose
10% PRE-PREPARED BAGS ARE COMMERCIALLY AVAILABLE
HOW TO PREPARE DIFFERENT CONCENTRATIONS OF GLUCOSE BAGS. DESIRED FINAL. CONCENTRATION. AMOUNT OF 10% GLUCOSE REQUIRED. AMOUNT OF 20% GLUCOSE REQUIRED. AMOUNT OF
10% Dextrose Injection USP
10% Dextrose Injection USP (concentrated dextrose in water) is a sterile
5% Dextrose Injection USP 10% Dextrose Injection
https://www.baxter.ca/sites/g/files/ebysai1431/files/2019-06/5pct10pct_Dextrose_Injections_USP_in_Viaflex_Plastic_Container_EN.pdf
El Dorado County Emergency Medical Services Agency Medication
Jul 1 2020 Dextrose 50%. (D50W
HIGHER DEXTROSE CONCENTRATION SOLUTION PREPARATION
12 May 2014 for a 100ml burette using 50%dextrose as the additive solution. ADD THE VOLUME OF 50% DEXTROSE TO THE VOLUME OF 10% DEXTROSE TO MAKE UP A ...
Fluid Management
To make a fluid with 10% dextrose. • Dilute at a ratio of 1:4. • For example take 200 ml 50% dextrose and add to 800 ml of 0.9% saline.
Making up intravenous fluids
MAKING INTRAVENOUS FLUIDS FOR 0.9% Sodium Chloride 10% glucose 500ml bag ... Method 1: If 0.45% Sodium Chloride with 5% dextrose is available.
BASIC PAEDIATRIC PROTOCOLS
in 9 mls water for injection to make 10mls 5mls/kg 10% dextrose IV over 3-5 mins page10 ... Adjust dosage to produce 2 - 3 soft stools per day.
Quick Concentrations Cheat Sheet (Using 50% Dextrose)
To make a 2.5% dextrose solution. Add 50 cc to 1000 mL. Add 25 cc to 500 mL. Add 12.5 cc to 250 mL. To make a 5% dextrose solution. Add 100 cc to 1000 mL.
ANNEXURE
dextrose (in mL) to be made up with 5% dextrose to make a total of 100 mL. For example to prepare 100ml of 10% dextrose from 5% dextrose and 25%.
10% Dextrose Injection USP
EN-2535. Page 1 of 4. 10% Dextrose Injection USP. CONCENTRATED DEXTROSE IN WATER. Concentrated source of carbohydrate calories for intravenous infusion.
Paediatric fluids 13/06/05
13 Jun 2005 Premature neonates may need 10% dextrose older babies. 5% dextrose. This may be with saline 0.45% (or 0.9% if the sodium is low).
5% Dextrose Injection USP 10% Dextrose Injection
https://www.baxter.ca/sites/g/files/ebysai1431/files/2019-06/5pct10pct_Dextrose_Injections_USP_in_Viaflex_Plastic_Container_EN.pdf
Neonatal Drug Formulary
Add 9.6ml of diluent to make a total of 10ml. Total amount =100mg in 10ml 10% or 5% Dextrose (D5 or D10) ... Add 8ml of water for injection to make 10ml.
[PDF] HIGHER DEXTROSE CONCENTRATION SOLUTION PREPARATION
12 mai 2014 · ADD THE VOLUME OF 50 DEXTROSE TO THE VOLUME OF 10 DEXTROSE TO MAKE UP A TOTAL OF 100 ML DESIRED DEXTROSE CONC VOLUME OF 10 DEXTROSE
[PDF] ANNEXURE - ontop
If 10 dextrose is being used multiply the figure obtained in (b) above by 100 to find out the Glucose Infusion Rate (GIR) in mg/kg/min (Since 10 Dextrose
GLUCOSE 10% = DEXTROSE 10% - MSF Medical Guidelines
If ready-made 10 glucose solution is not available: remove 100 ml of 5 glucose from a 500 ml bottle or bag then add 50 ml of 50 glucose to the remaining
[PDF] 10% Dextrose Injection USP
Concentrated dextrose solutions should not be administered subcutaneously or intramuscularly Do not administer unless solution is clear and container is
[PDF] Chart 10 How to give glucose intravenously - NCBI
Give 5 ml/kg of 10 glucose solution rapidly by IV injection Age (weight) milk or sugar solution via a nasogastric tube (to make sugar solution
[PDF] Dextrose 10% or 50% in the treatment of hypoglycaemia out - NCBI
29 déc 2004 · Objective: To investigate whether 10 dextrose given in 5 g (50 ml) aliquots is more effective than 50 dextrose given in 5 g (10 ml)
[PDF] Making up intravenous fluids - BIMDG
b) To the remainder of the bag add 56ml of 50 glucose Method 2: Using a 500 ml bag of 10 glucose Add 15ml of the 30 sodium chloride concentrate
Quick Concentrations Cheat Sheet (Using 50% Dextrose)
To make a 2 5 dextrose solution Add 50 cc to 1000 mL Add 25 cc to 500 mL Add 12 5 cc to 250 mL To make a 5 dextrose solution Add 100 cc to 1000 mL
[PDF] 5% Dextrose Injection USP 10% Dextrose Injection USP
11 jui 2019 · 5 Dextrose Injection USP and 10 Dextrose Injection USP are sterile nonpyrogenic solutions for fluid replenishment and
How to make 10% of dextrose?
If ready-made 10% glucose solution is not available: remove 100 ml of 5% glucose from a 500 ml bottle or bag, then add 50 ml of 50% glucose to the remaining 400 ml of 5% glucose to obtain 450 ml of 10% glucose solution.How to make 10% glucose from 50%?
If ready-made 10% glucose solution is not available: add 10 ml of 50% glucose per 100 ml of 5% glucose to obtain a 10% glucose solution.How to make 10% dextrose from 25% dextrose?
For example, to prepare 100ml of 10% dextrose from 5% dextrose and 25% dextrose, add 5x10-25=25ml of 25% dextrose to the remaining volume, i.e. 100- 25 =75 ml of 5% dextrose.- Glucose 10% w/v Solution for Infusion. Each ml contains 100 mg glucose (as monohydrate).
Dr Catharine Wilson
Consultant Paediatric Anaesthetist
Sheffield Children's Hospital. UK
Paediatric fluids 13/06/05
Self assessment:
Complete these questions before reading the tutorial. Discuss the answers with your colleagues. 1. How long should children be fasted pre-operatively? 2. For what reasons may you need to give fluids intra-operatively? 3.How do you calculate fluid requirements?
4.What is the maintenance requirement for:
i. a 3 day old 3 kg neonate ii. a 16 kg child iii. a 44 kg child 5.Define isotonic and hypotonic
6. List the intravenous fluids you know. Which are isotonic, which are hypotonic? 7. What factors may cause hyponatraemia peri-operatively? 8.What are the signs and symptoms of hyponatraemia?
9.Which children are at risk of hypoglycaemia?
10.What fluids can you use for:
i. maintenance infusion? ii. correction of hypovolaemia? iii. replacement of intraoperative lossesIntroduction
The majority of fit paediatric patients undergoing minor surgery will not require intravenous fluids per-operatively. These patients should be kept nil by mouth as short a time as possible to minimise the discomfort of hunger and thirst. In elective surgery clear fluids should be allowed up to 2 hours pre-operatively, breast milk to 3 hours. All other food or fluids (including formula milk) should be withheld for 6 hours pre-anaesthetic. Patients undergoing longer or more major procedures, or who are compromised by an underlying illness will need intravenous fluids.When should fluids be given?
Fluids are given for three reasons: resuscitation, maintenance or replacement of ongoing losses. Resuscitation of a dehydrated or hypovolaemic patient should occur prior to surgery where possible to ensure an adequate circulation before giving an anaesthetic.Hypovolaemia may be corrected rapidly using is
otonic saline (0.9%), colloid or blood as appropriate. Dehydration should be corrected more slowly (over 24-48 hours) and preferably with oral fluids. The choice of intravenous fluid used will depend on the measured plasma sodium. Too rapid correction with hypotonic fluid may cause hyponatraemia and result in cerebral oedema which can be fatal. Maintenance may be with any clear fluid. However some of these are hypotonic solutions which may cause hyponatraemia if given in large amounts or over a long period of time. An isotonic fluid contains the same amount of solute as plasma so exerts an equal osmotic force. e.g. 0.9% saline or Hartmanns solution (Ringers lactate). Dextrose is metabolised in blood, so although 5% dextrose is isosmolar to plasma, once metabolised it becomes effectively free water. 0.45% or 0.18% saline, and dextrose solutions are therefore hypotonic. When the body is subject to stress such as surgery, pain, nausea or hypovolaemia, levels of antidiuretic hormone (ADH) rise. This causes water retention by the kidneys which dilutes and lowers plasma sodium levels. A rapid or large drop in sodium results in cell swelling and oedema. This can manifest as raised intracranial pressure, coning and death. This suggests that perioperative maintenance fluids should be given as 0.45% saline,0.9% saline or Hartmanns. Hypotonic fluids should not be used if the sodium is less than
140 mmol/l. If the plasma electrolyes are not known it is probably safer (in the short
term) to give 0.9% saline to a patient with a high sodium, than to give hypotonic fluids to a hyponataemic patient. Hypotonic fluids should not normally be given at greater than maintenance rates (except in neonates, see below). Replacement of ongoing losses during or after surgery should be with an isotonic fluid, colloid or blood. Increased fluid evaporation occurs in pyrexia, from an open wound (up to 20 ml/kg/hour) or by breathing dry anaesthetic gasses. Respiratory fluid loss can be reduced by using a circle system or HME (heat moisture exchanger). Blood or other fluid loss may be difficult to measure and the clinical state should be monitored continuously (heart rate, capillary refill time and blood pressure). In a warm, stable child with good analgesia increased heart rate and prolonged capillary refill time indicate fluid loss. Hypotension occurs relatively late when due to hypovolaemia.When should dextrose solutions be used?
Dextrose may be required to prevent hypoglycaemia while the child is fasted for theatre. However the stress response to starvation and surgery causes a rise in blood sugar, and per-operative hypoglycaemia is actually rare in most children, even those not given dextrose fluids. The exceptions to this are: neonates less than 48 hours old; neonates who have a dextrose infusion st opped; and children below the 3 rd centile in weight. These children should be given dextrose maintenance infusions without prolonged interruption. The choice of dextrose containing fluid will depend on local preference and measured blood glucose and electrolytes. Premature neonates may need 10% dextrose, older babies5% dextrose. This may be with saline 0.45% (or 0.9% if the sodium is low). Most other
children can be given dextrose-free fluid. Any child thought to be at risk of hypoglycaemia should have their blood glucose checked regularly.Calculation of fluids
Maintenance fluid rate may be calculated many different ways. A simple method follows:Body weight
1-10 kg 4 ml/kg/hour
10-20 kg 40 ml + 2 ml/kg/hour above 10kg
> 20 kg 60 ml + 1 ml/kg/hour above 20kg Neonates (up to 44 weeks post conceptual age) have different requirements. They are born physiologically "waterlogged" then lose th is fluid over the first week of life. Premature or small babies have a larger surface area to weight ration so will lose more fluids by evaporation and therefore have higher maintenance requirements. This fluid is usually given as 10% dextrose with or without saline to maintain blood sugar. Weight / age< 1.0 kg1.0 - 1.5 kg1.5 - 2.0 kg> 2.0 kgFluid requirement ml/kg/day
Day 1 100 - 120 80 - 100 60 - 80 40 - 60
Day 2 120 - 150 110 - 130 90 - 110 60 - 90
Day 3 150 - 170 140 - 160 120 - 140 80 - 100
Day 4 180 - 200 160 - 180 140 - 160 100 - 120
Day 5 and after 180 - 200 170 - 200 150 - 180 120 - 150Post-operative fluids and monitoring
Monitoring of fluid status s
hould continue post-operatively. Maintenance fluids should be continued until the child is able to take adequate amounts orally. Ongoing losses should be measured and replaced. Symptoms of raised intracranial pressure include nausea, vomiting, reduced consciousness, respiratory depression and seizures. Nausea, vomiting and drowsiness may be attributed to the side effects of surgery, anaesthesia and analgesia but by the onset of seizures and respiratory depression due to hyponatraemic encephalopathy, it may be too late.Suggested fluid regime
Maintenance infusion calculated on weight basis using 0.9% or 0.45% saline. Additional fluid to correct deficits, measured or suspected ongoing losses:0.9% saline, colloid or blood.
Dextrose if neonate, malnourished or a measured blood sugar is low.Give as 5% or 10% dextrose at 120 mg/kg/hour.
Conclusions:
The majority of fit paediatric patients undergoing minor surgery will re-establish oral intake in the early postoperative phase and will not need routine intravenous fluids. Hypotonic fluids should be used with care and must not be infused in large volumes or at greater than maintenance rates. Hypovolaemia should be corrected with rapid infusion of isotonic saline, while dehydration is corrected more slowly over 14-72 hours as appropriate.Ongoing losses should be measured and replaced.
Plasma electrolytes and glucose should be measured regularly in any child requiring large volumes of fluid or who remains on intravenous fluids for more than 24 hours.Further reading
Wilson CM. Perioperative fluids in children. Update in Anaesthesia Issue 19 (2005) www.world-anaesthesia.org.Answers to questions:
1. How long should children be fasted for pre-operatively?A: See text
2. For what reasons may you need to give fluids intra-operatively? A: Resuscitation, maintenance and replacement. See text 3.How do you calculate fluid requirements?
A: The "4-2-1 rule" is a quick method for calculating fluids except in neonates who have different requirements. See text. 4.What is the maintenance requirement for:
i. a 3 day old 3 kg neonate A:80-100 ml/kg/24 hours. See table.
ii. a 16 kg childA: 52 ml/hour. [40ml + (2 x 6ml)]. See text.
iii. a 44 kg childA: 84 ml/hour. [60ml + (24 x 1ml)]. See text.
5.Define isotonic and hypotonic
A: an isotonic fluid exerts the same osmotic force as plasma. A hypotonic fluid exerts a lower osmotic force than plasma. This is either because the concentration of solutes is lower than in plasma, or because the solute is metabolised, diluting the plasma and leaving free water to move into cells. This may result in hyponatraemia (a low plasma sodium). 6. List all the fluids you know. Which are isotonic, which are hypotonic? fluid Solutes: mmol /litre tonicity notes0.9% saline Na 150
Cl 150
isotonicHartmanns
(Ringers lactate)Na 131
K 4 Ca 2 Mg 2Cl 111
Bicarb 29
isotonic Although almost isotonic, this fluid still has a lower sodium than plasma and may result in hyponatraemia if given over a prolonged period of time.0.45% saline Na 75
Cl 75 hypotonic0.45% saline /
5% dextrose Na 75
Cl 75Dextrose 50 mg/ml
hypotonic0.18% saline Na 30
Cl 30 hypotonic10% dextrose Dextrose 100
mg/ml hypotonic5% dextrose Dextrose 50 mg/ml hypotonic
7. What factors may cause hyponatraemia peri-operatively? A: Stress causing a rise in ADH levels and water retention. Rapid infusion of hypotonic fluids (at greater than maintenance rates). Prolonged infusion of hypo tonic fluids. NB prolonged infusion of isotonic fluids may also result in hypernatraemia. Any patient on intravenous fluids should have their plasma electrolytes checked on a regular basis (at least every 24 hours). 8.What are the signs and symptoms of hyponatraemia?
A: Oedema, including cerebral oedema. The signs of raised intracranial pressure may be mistaken for the side effects of anaesthesia. See text. 9.Which children are at risk of hypoglycaemia?
A: See text
10.What fluids can you use for:
i. maintenance infusion? ii. correction of hypovolaemia? iii. replacement of intraoperative lossesA: See text.
Please e-mail any questions to: catharinewilson@yahoo.co.ukquotesdbs_dbs10.pdfusesText_16[PDF] how to make 7.5% dextrose solution
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