Continuous IV Fluid Administration Clinical Pathway — Inpatient

Healthy Child Over 12 Months Old Who is NPO for Procedure/sedation/anesthesia

  • Do not start continuous IV fluids or administer a bolus at start of NPO time
  • Administer the first 20 ml/kg bolus approximately 6 hours after beginning of NPO time (Anesthesia prefers bolus be administered by 0600 for morning cases)
  • Re-assess and consider administering a second 20 ml/kg normal saline bolus 6-8 hours after initial bolus
  • Monitor clinically for signs of hypoglycemia
  • Initiate dextrose-containing maintenance fluids according to the pathway if NPO time will exceed 18-24 hours
  • This is an effort to decrease PIV infiltrates from continuous maintenance fluids. Additional benefits include:
    • Alleviates the need for hourly PIV checks that may awaken the patient (especially overnight).
    • Eliminate requirement for the child to be tethered to a pole.
  • Exclusion criteria:
    • Age < 12 months
    • Severe illness
    • Gastroenteritis or other ongoing losses
    • Concern for electrolyte imbalances or hypoglycemia
    • Minimal PO intake in the 12-24 hours prior to NPO start time