If a patient presents with hypovolemia, say due to vomiting, why would you not start them out on plasmalyte or LR? I understand the cost may be more, but is cost the only reason? What amount would typically be "too much" NS? I get that the body would compensate by releasing bicarb into the blood if acidosis was happening, but why not make it easier on the body?
This was an excellent video. We were arguing that NS does not have the same osmolality as the body, but typically higher when it comes to sodium chloride. In addition, the osmolality is barely within normal range. It was great that you mentioned that the patient can become expansion acidosis after too much usage.
Thank you very much for sharing. Ver, very helpful learning tool, Very simplified ,easy to understand teaching. I will definiteley follow your other teachings.
Also its misleading to say ringers contain bicarbonate. It doesn't, however the lactate is converted to bicarbonate in the liver in a ratio 1:1. Hence 27meq of bicarbonate is converted to 27meq. Ringers is actually containing 4 ingredients Sodium lactate, Sodium Chloride, Potassium Chloride,and Calcium Chloride(dihydrate)
Getting ready to start residency and this has been one topic that I’m truly embarrassed to say I never learned. Other than 4:2:1 rule and dumb junk like that.
There are several studies and a Cochrane systematic review showing no differences between normal saline and buffered solutions. Plus, there are more and more incoming information advocating against high volumes resuscitation, so. Instead of using useless solutions, start assessing volume overload/depletion before and, in a surgical scenario, use blood to resucitaste, please
Probably want to figure out that Na imbalance problem then figure out the fluids. Like is it hypervolemic hyponatremia bc the pt's sugar is 600 and all that glucose is pulling water into the blood stream? Or conversely say hypervolemic hyponatremia bc the pt hiked all day and just drank water with no salty snacks; then maybe do the furosemide with your saline. I forgot the rule, but something like no more than 12MEQ change in 24 hours or you'll get neurological problems.
We will have to resuscitate the patient in such a case. The type of fluid will depend on the degree of burn, but in severe cases fluids like ringer lactate can be used.
If a person has diabetic ketoacidosis we give normal saline( ph5.5)but pH of lactic acid is 6.5 then why are we giving normal saline in acidosis if it's pH is 5.5
My opinion that the problem isn’t PH itself the problem with DKA is dehydration so we correct it to help the body to excrete the ketones & we give K with it as will before giving the insulin so if the ketones excreted the ph will improve Another point ( NaCL will not affect the ph significantly in acute sittings )only if used for long time here we have to put ph level in mind
Actually the preparation of ringers depending on the manufacturer the total mOsm/l is between 274 - 277mOsm/l If you look Na is 130 Cl is 111 K is 4 to 5 , Ca is 2 to 4 , lactate 27 adding the individual mOsm gives you a solution within that range. The normal range of osmolality of blood is around is actually 275 to 295mOsm/L
This was fantastic and video to watch before rotating on the ICU!
Highly recommended. I love how it was presented. Comprehensive and straight to the point.
Thank you for this video.
❤😅😢😢😢😅😮
This is what i have been looking for 😢😢....
😭😭
I’ve been searching everywhere for this exact video topic!
Thank you!!!!❤️❤️❤️
loved it; I watched it during the last hour of my first on-call.
Man I love your video explanation. I’ve watch so many and still confused u made clarity for me. How u don’t have more comments I don’t understand
Best explanation I have seen
oh, wow! thank you SO MUCH! Why don't they teach this in school??
Thank you! This explanation is exactly what I needed. Appreciate all the good you’re putting out there ✨
Thank you so muchhhhhh. This was really helpful. Looking forward to more of these videos.
Great video!
This video saved my life at my practice thank you
This helped a lot and was simple to understand, thank you!
helpful
Vaiii! Perfect!
Thank you so much👏🏾
If a patient presents with hypovolemia, say due to vomiting, why would you not start them out on plasmalyte or LR? I understand the cost may be more, but is cost the only reason?
What amount would typically be "too much" NS? I get that the body would compensate by releasing bicarb into the blood if acidosis was happening, but why not make it easier on the body?
Good graphics and well explained.
This was an excellent video. We were arguing that NS does not have the same osmolality as the body, but typically higher when it comes to sodium chloride. In addition, the osmolality is barely within normal range. It was great that you mentioned that the patient can become expansion acidosis after too much usage.
THANK YOU so much for the video! great way to explain it and so glad I found it!
I saw the title of this video and said fuck from relief
Thank you very much for sharing.
Ver, very helpful learning tool, Very simplified ,easy to understand teaching.
I will definiteley follow your other teachings.
Thank you for simplifying this!
Also its misleading to say ringers contain bicarbonate. It doesn't, however the lactate is converted to bicarbonate in the liver in a ratio 1:1. Hence 27meq of bicarbonate is converted to 27meq. Ringers is actually containing 4 ingredients Sodium lactate, Sodium Chloride, Potassium Chloride,and Calcium Chloride(dihydrate)
Nice copy and paste, now foh
Great. Thanks for this videom
I loved it . too easy to remember .
Please which one can I go for? I'm not I'll at all I just want to hydrate myself. Which of these is best to go for please?
Getting ready to start residency and this has been one topic that I’m truly embarrassed to say I never learned. Other than 4:2:1 rule and dumb junk like that.
There are several studies and a Cochrane systematic review showing no differences between normal saline and buffered solutions. Plus, there are more and more incoming information advocating against high volumes resuscitation, so. Instead of using useless solutions, start assessing volume overload/depletion before and, in a surgical scenario, use blood to resucitaste, please
Probably want to figure out that Na imbalance problem then figure out the fluids. Like is it hypervolemic hyponatremia bc the pt's sugar is 600 and all that glucose is pulling water into the blood stream? Or conversely say hypervolemic hyponatremia bc the pt hiked all day and just drank water with no salty snacks; then maybe do the furosemide with your saline. I forgot the rule, but something like no more than 12MEQ change in 24 hours or you'll get neurological problems.
Thank you so much 💗
D5W IS 252 not 50.. 50mg is in 1L but that's equal to 252meq/L. D5W IS HYDROUS DEXTROSE.(5%)
Why are pediatric patients given dextrose 4.3 saline 0.18?
Very good explanation! Thank you!
how to calculate osmolarity of 5% dextrose in normal saline
Greatly simplified...thank you so much ..!!
Wow, thank you
Simple and clear. Thx
didnt know Pathoma had a section on fluids
Its just a great explanation
Thank youuuu
Damn this was really helpful, thank you!! :)
Thank u sooo much ❤
I appreciate the effort but video seems incomplete though. What about situation like burns ?
What ifthere is blood loss.
Ringers Lactate is commonly used to replace fluid loss. Given as a bolus in low blood pressure, burns, trauma situations, etc.
We will have to resuscitate the patient in such a case. The type of fluid will depend on the degree of burn, but in severe cases fluids like ringer lactate can be used.
Thank you
short sweet and super !!
Regarding the D5W doesnt it cause hypertonicity since it has a higher osmolarity?
But it's osmolality is 252, which is hypotonic so no
dextrose is used up by the cells, making free water in the vascular system, making D5W hypotonic
Thank you 😊
U are the best….. thank you!!! 😌
Thank yooou♥️♥️♥️♥️♥️♥️
🙏🏻🙏🏻Thank you! 🌺🌸🌺🌸
If a person has diabetic ketoacidosis we give normal saline( ph5.5)but pH of lactic acid is 6.5 then why are we giving normal saline in acidosis if it's pH is 5.5
My opinion that the problem isn’t PH itself the problem with DKA is dehydration so we correct it to help the body to excrete the ketones & we give K with it as will before giving the insulin so if the ketones excreted the ph will improve
Another point ( NaCL will not affect the ph significantly in acute sittings )only if used for long time here we have to put ph level in mind
great
Very Good ....😀
Osmosis guy?
Why would you give anything with sugar to someone with a BG of 160?
i thought same. i think he meant to say sodium instead of sugar??
How come Lactated Ringers is mOsm/L 273 but still considered Isotonic when the minimum mOsm/L for blood is 280?
273 is preeeeetttttyyy, preeeetty, pretty close to 280.
Actually the preparation of ringers depending on the manufacturer the total mOsm/l is between 274 - 277mOsm/l
If you look Na is 130 Cl is 111 K is 4 to 5 , Ca is 2 to 4 , lactate 27 adding the individual mOsm gives you a solution within that range. The normal range of osmolality of blood is around is actually 275 to 295mOsm/L
watching grey's led me here
the sound is not good I am quite disappointed
❤
You speek very rapidly
what the hell cold voice?
You say "why" too many times. Bad habit making a video.
Thank you
Thank you