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