World Journal of Emergency Medicine ›› 2018, Vol. 9 ›› Issue (1): 13-19.doi: 10.5847/wjem.j.1920-8642.2018.01.002
• Original Articles • Previous Articles Next Articles
Wing Yan Shirley Cheung(
), Wai Kwan Cheung, Chun Ho Lam, Yeuk Wai Chan, Hau Ching Chow, Ka Lok Cheng, Yau Hang Wong, Chak Wah Kam
Received:2016-12-22
Accepted:2017-05-06
Online:2018-03-15
Published:2018-03-15
Contact:
Wing Yan Shirley Cheung
E-mail:scheung1031@gmail.com
Wing Yan Shirley Cheung, Wai Kwan Cheung, Chun Ho Lam, Yeuk Wai Chan, Hau Ching Chow, Ka Lok Cheng, Yau Hang Wong, Chak Wah Kam. Intravenous fluid selection rationales in acute clinical management[J]. World Journal of Emergency Medicine, 2018, 9(1): 13-19.
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URL: http://wjem.com.cn//EN/10.5847/wjem.j.1920-8642.2018.01.002
Table 1
Hypovolemic shock due to dehydration (n=100)
| Parameters | Doctor (%) | Nurse (%) | Total | P-value | |
|---|---|---|---|---|---|
| IVF | 5% Dextrose | 0 (0.00) | 1 (3.33) | 1 | 0.04 |
| 1/3 - 3.3% Dextrose + 0.3% NaCl | 1 (1.43) | 0 (0.00) | 1 | ||
| Lactated ringer's and Hartmann | 4 (5.71) | 3 (10.00) | 7 | ||
| 0.9% sodium chloride | 42 (60.00) | 19 (63.33) | 61 | ||
| Plasma-Lyte A | 16 (22.86) | 1 (3.33) | 17 | ||
| Gelofusine | 7 (10.00) | 6 (20.00) | 13 | ||
| Plasma/plasma protein fraction (PPF) | 0 (0.00) | 0 (0.00) | 0 | ||
| Others | 0 (0.00) | 0 (0.00) | 0 | ||
| Reason | Readily available | 11 (15.71) | 5 (16.67) | 16 | 0.137 |
| Undergraduate knowledge | 7 (10.00) | 6 (20.00) | 13 | ||
| Personal routine | 13 (18.57) | 0 (0.00) | 13 | ||
| Departmental practice | 18 (25.71) | 8 (26.67) | 26 | ||
| Directed by supervisor | 11 (15.71) | 7 (23.33) | 18 | ||
| Working department training | 5 (7.14) | 2 (6.67) | 7 | ||
| Professional college guidelines | 1 (1.43) | 0 (0.00) | 1 | ||
| Clinical handbook | 0 (0.00) | 1 (3.33) | 1 | ||
| Medical literature review | 2 (2.86) | 1 (3.33) | 3 | ||
| Others | 2 (2.86) | 0 (0.00) | 2 | ||
Table 2
Hypovolemic shock due to extensive burns (n=100)
| Parameters | Doctor (%) | Nurse (%) | Total | P-value | |
|---|---|---|---|---|---|
| IVF | 5% Dextrose | 1 (1.43) | 1(3.33) | 2 | 0.361 |
| 1/3 - 3.3% Dextrose + 0.3% NaCl | 0 (0.00) | 0 (0.00) | 0 | ||
| Lactated ringer's and Hartmann | 18 (25.71) | 9 (30.00) | 27 | ||
| 0.9% sodium chloride | 26 (37.14) | 11 (36.67) | 37 | ||
| Plasma-Lyte A | 13 (18.57) | 2 (6.67) | 15 | ||
| Gelofusine | 9 (12.86) | 3 (10.00) | 12 | ||
| Plasma/plasma protein fraction (PPF) | 0 (0.00) | 1 (3.33) | 1 | ||
| Others | 3 (4.29) | 3 (10.00) | 6 | ||
| Reason | Readily available | 5 (7.14) | 2 (6.67) | 7 | 0.326 |
| Undergraduate knowledge | 10 (14.29) | 7 (23.33) | 17 | ||
| Personal routine | 8 (11.43) | 2 (6.67) | 10 | ||
| Departmental practice | 23 (32.86) | 8 (26.67) | 31 | ||
| Directed by supervisor | 11 (15.71) | 5 (16.67) | 16 | ||
| Working department training | 5 (7.14) | 1 (3.33) | 6 | ||
| Professional college guidelines | 4 (5.71) | 0 (0.00) | 4 | ||
| Clinical handbook | 0 (0.00) | 2 (6.67) | 2 | ||
| Medical literature review | 2 (2.86) | 3 (10.00) | 5 | ||
| Others | 2 (2.86) | 0 (0.00) | 2 | ||
Table 3
Hemorrhagic shock from acute gastrointestinal bleeding (n=100)
| Parameters | Doctor (%) | Nurse (%) | Total | P-value | |
|---|---|---|---|---|---|
| IVF | 5% Dextrose | 0 (0.00) | 1(3.33) | 1 | 0.005 |
| 1/3 - 3.3% Dextrose + 0.3% NaCl | 1 (1.43) | 0 (0.00) | 1 | ||
| Lactated ringer's and Hartmann | 1 (1.43) | 2 (6.67) | 3 | ||
| 0.9% sodium chloride | 31 (44.29) | 12 (40.00) | 43 | ||
| Plasma-Lyte A | 16 (22.86) | 2 (6.67) | 18 | ||
| Gelofusine | 20 (28.57) | 7 (23.33) | 27 | ||
| Plasma/plasma protein fraction (PPF) | 0 (0.00) | 3 (10.00) | 3 | ||
| Others | 1 (1.43) | 3 (10.00) | 4 | ||
| Reason | Readily available | 8 (11.43) | 2 (6.67) | 10 | 0.057 |
| Undergraduate knowledge | 5 (7.14) | 6 (20.00) | 11 | ||
| Personal routine | 14 (20.00) | 1 (3.33) | 15 | ||
| Departmental practice | 30 (42.86) | 10 (33.33) | 40 | ||
| Directed by supervisor | 6 (8.57) | 7 (23.33) | 13 | ||
| Working department training | 1 (1.43) | 2 (6.67) | 3 | ||
| Professional college guidelines | 1 (1.43) | 0 (0.00) | 1 | ||
| Clinical handbook | 2 (2.86) | 1 (3.33) | 3 | ||
| Medical literature review | 2 (2.86) | 1 (3.33) | 3 | ||
| Others | 1 (1.43) | 0 (0.00) | 1 | ||
Table 4
Traumatic hemorrhagic shock (n=100)
| Parameters | Doctor (%) | Nurse (%) | Total | P-value | |
|---|---|---|---|---|---|
| IVF | 5% Dextrose | 1 (1.43) | 1 (3.33) | 2 | 0.066 |
| 1/3 - 3.3% Dextrose + 0.3% NaCl | 0 (0.00) | 0 (0.00) | 0 | ||
| Lactated ringer's and Hartmann | 4 (5.71) | 3 (10.00) | 7 | ||
| 0.9% sodium chloride | 36 (51.43) | 13 (43.33) | 49 | ||
| Plasma-Lyte A | 12 (17.14) | 1 (3.33) | 13 | ||
| Gelofusine | 15 (21.43) | 7 (23.33) | 22 | ||
| Plasma/plasma protein fraction (PPF) | 0 (0.00) | 1 (3.33) | 1 | ||
| Others | 2 (2.86) | 4 (13.33) | 6 | ||
| Reason | Readily available | 8 (11.43) | 1 (3.33) | 9 | 0.114 |
| Undergraduate knowledge | 3 (4.29) | 7 (23.33) | 10 | ||
| Personal routine | 9 (12.86) | 1 (3.33) | 10 | ||
| Departmental practice | 23 (32.86) | 8 (26.67) | 10 | ||
| Directed by supervisor | 13 (18.57) | 8 (26.67) | 31 | ||
| Working department training | 4 (5.71) | 1 (3.33) | 21 | ||
| Professional college guidelines | 3 (4.29) | 0 (0.00) | 5 | ||
| Clinical handbook | 3 (4.29) | 1 (3.33) | 3 | ||
| Medical literature review | 2 (2.86) | 2 (6.67) | 4 | ||
| Others | 2 (2.86) | 1 (3.33) | 3 | ||
Table 5
Cardiogenic shock (n=100)
| Parameters | Doctor (%) | Nurse (%) | Total | P-value | |
|---|---|---|---|---|---|
| IVF | 5% Dextrose | 1 (1.43) | 1 (3.33) | 2 | 0.001 |
| 1/3 - 3.3% Dextrose + 0.3% NaCl | 1 (1.43) | 0 (0.00) | 1 | ||
| Lactated ringer's and Hartmann | 4 (5.71) | 0 (0.00) | 4 | ||
| 0.9% sodium chloride | 37 (52.86) | 13 (43.33) | 50 | ||
| Plasma-Lyte A | 15 (21.43) | 0 (0.00) | 15 | ||
| Gelofusine | 7 (10.00) | 7 (23.33) | 14 | ||
| Plasma/plasma protein fraction (PPF) | 0 (0.00) | 0 (0.00) | 0 | ||
| Others | 5 (7.14) | 9 (30.00) | 14 | ||
| Reason | Readily available | 11 (15.71) | 3 (10.00) | 14 | 0.029 |
| Undergraduate knowledge | 6 (8.57) | 6 (20.00) | 12 | ||
| Personal routine | 12 (17.14) | 0 (0.00) | 12 | ||
| Departmental practice | 24 (34.29) | 8 (26.67) | 32 | ||
| Directed by supervisor | 9 (12.86) | 8 (26.67) | 17 | ||
| Working department training | 4 (5.71) | 2 (6.67) | 6 | ||
| Professional college guidelines | 1 (1.43) | 0 (0.00) | 1 | ||
| Clinical handbook | 0 (0.00) | 1 (3.33) | 1 | ||
| Medical literature review | 2 (2.86) | 0 (0.00) | 2 | ||
| Others | 1 (1.43) | 2 (6.67) | 3 | ||
Table 6
Septic shock (n=100)
| Parameters | Doctor (%) | Nurse (%) | Total | P-value | |
|---|---|---|---|---|---|
| IVF | 5% Dextrose | 0 (0.00) | 1 (3.33) | 1 | 0.035 |
| 1/3 - 3.3% Dextrose + 0.3% NaCl | 1 (1.43) | 0 (0.00) | 1 | ||
| Lactated ringer's and Hartmann | 2 (2.86) | 2 (6.67) | 4 | ||
| 0.9% sodium chloride | 37 (52.86) | 20 (66.67) | 57 | ||
| Plasma-Lyte A | 16 (22.86) | 1 (3.33) | 17 | ||
| Gelofusine | 13 (18.57) | 4 (13.33) | 17 | ||
| Plasma/plasma protein fraction (PPF) | 0 (0.00) | 0 (0.00) | 0 | ||
| Others | 1 (1.43) | 2 (6.67) | 3 | ||
| Reason | Readily available | 14 (20.00) | 3 (10.00) | 17 | 0.18 |
| Undergraduate knowledge | 5 (7.14) | 6 (20.00) | 11 | ||
| Personal routine | 12 (17.14) | 1 (3.33) | 13 | ||
| Departmental practice | 20 (28.57) | 12 (40.00) | 32 | ||
| Directed by supervisor | 11 (15.71) | 5 (16.67) | 16 | ||
| Working department training | 4 (5.71) | 1 (3.33) | 5 | ||
| Professional college guidelines | 1 (1.43) | 0 (0.00) | 1 | ||
| Clinical handbook | 0 (0.00) | 1 (3.33) | 1 | ||
| Medical literature review | 2 (2.86) | 1 (3.33) | 3 | ||
| Others | 1 (1.43) | 0 (0.00) | 1 | ||
Table 7
Anaphylactic shock (n=100)
| Parameters | Doctor (%) | Nurse (%) | Total | P-value | |
|---|---|---|---|---|---|
| IVF | 5% Dextrose | 0 (0.00) | 1 (3.33) | 1 | 0.007 |
| 1/3 - 3.3% Dextrose+ 0.3% NaCl | 0 (0.00) | 0 (0.00) | 0 | ||
| Lactated ringer's and Hartmann | 1 (1.43) | 5 (16.67) | 6 | ||
| 0.9% sodium chloride | 35 (50.00) | 16 (53.33) | 51 | ||
| Plasma-Lyte A | 20 (28.57) | 2 (6.67) | 22 | ||
| Gelofusine | 11 (15.71) | 5 (16.67) | 16 | ||
| Plasma/plasma protein fraction (PPF) | 1 (1.43) | 0 (0.00) | 1 | ||
| Others | 2 (2.86) | 1 (3.33) | 3 | ||
| Reason | Readily available | 10 (14.29) | 4 (13.33) | 14 | 0.768 |
| Undergraduat knowledge | 8 (11.43) | 6 (20.00) | 14 | ||
| Personal routine | 9 (12.86) | 1 (3.33) | 10 | ||
| Departmental practice | 21 (30.00) | 10 (33.33) | 31 | ||
| Directed by supervisor | 12 (17.14) | 5 (16.67) | 17 | ||
| Working department training | 5 (7.14) | 2 (6.67) | 7 | ||
| Professional college guidelines | 1 (1.43) | 0 (0.00) | 1 | ||
| Clinical handbook | 0 (0.00) | 1 (3.33) | 1 | ||
| Medical literature review | 3 (4.29) | 1 (3.33) | 4 | ||
| Others | 1 (1.43) | 0 (0.00) | 1 | ||
Table 8
Obstructive shock due to pericardial tamponade (n=100)
| Parameters | Doctor (%) | Nurse (%) | Total | P-value | |
|---|---|---|---|---|---|
| IVF | 5% Dextrose | 1 (1.43) | 1 (3.33) | 2 | 0.001 |
| 1/3 - 3.3% Dextrose + 0.3% NaCl | 0 (0.00) | 0 (0.00) | 0 | ||
| Lactated ringer's and Hartmann | 5 (7.14) | 0 (0.00) | 5 | ||
| 0.9% sodium chloride | 40 (57.14) | 13 (43.33) | 53 | ||
| Plasma-Lyte A | 15 (21.43) | 3 (10.00) | 18 | ||
| Gelofusine | 5 (7.14) | 1 (3.33) | 6 | ||
| Plasma/plasma protein fraction (PPF) | 0 (0.00) | 1 (3.33) | 1 | ||
| Others | 4 (5.71) | 11 (36.67) | 15 | ||
| Reason | Readily available | 8 (11.43) | 3 (10.00) | 11 | 0.005 |
| Undergraduate knowledge | 6 (8.57) | 5 (16.67) | 11 | ||
| Personal routine | 11 (15.71) | 1 (3.33) | 12 | ||
| Departmental practice | 30 (42.86) | 5 (16.67) | 35 | ||
| Directed by supervisor | 6 (8.57) | 8 (26.67) | 14 | ||
| Working department training | 5 (7.14) | 1 (3.33) | 6 | ||
| Professional college guidelines | 2 (2.86) | 2 (6.67) | 4 | ||
| Clinical handbook | 0 (0.00) | 1 (3.33) | 1 | ||
| Medical literature review | 1 (1.43) | 1 (3.33) | 2 | ||
| Others | 1 (1.43) | 3 (10.00) | 4 | ||
Table 9
Cardiac arrest (n=100)
| Parameters | Doctor (%) | Nurse (%) | Total | P-value | |
|---|---|---|---|---|---|
| IVF | 5% Dextrose | 0 (0.00) | 0 (0.00) | 0 | 0.000 |
| 1/3 - 3.3% Dextrose + 0.3% NaCl | 0 (0.00) | 1 (3.33) | 1 | ||
| Lactated ringer's and Hartmann | 2 (2.86) | 1 (3.33) | 3 | ||
| 0.9% sodium chloride | 45 (64.29) | 15 (50.00) | 60 | ||
| Plasma-Lyte A | 17 (24.28) | 1 (3.33) | 18 | ||
| Gelofusine | 6 (8.57) | 10 (33.33) | 16 | ||
| Plasma/plasma protein fraction (PPF) | 0 (0.00) | 0 (0.00) | 0 | ||
| Others | 0 (0.00) | 2 (6.67) | 2 | ||
| Reason | Readily available | 11 (15.71) | 5 (16.67) | 16 | 0.092 |
| Undergraduate knowledge | 2 (2.86) | 4 (13.33) | 6 | ||
| Personal routine | 12 (17.14) | 1 (3.33) | 13 | ||
| Departmental practice | 28 (40.00) | 7 (23.33) | 35 | ||
| Directed by supervisor | 8 (11.43) | 7 (23.33) | 15 | ||
| Working department training | 4 (5.71) | 2 (6.67) | 6 | ||
| Professional college guidelines | 1 (1.43) | 0 (0.00) | 1 | ||
| Clinical handbook | 2 (2.86) | 2 (6.67) | 4 | ||
| Medical literature review | 1 (1.43) | 1 (3.33) | 2 | ||
| Others | 1 (1.43) | 1 (3.33) | 2 | ||
Table 10.
Sufficiency of IVF guideline, training and revision (n=100)
| Parameters | Doctor | Nurse | Total | P-value | |
|---|---|---|---|---|---|
| Guidelines | Mean | 5.04 | 4.8 | 4.97 | 0.459 |
| Median | 5 | 5 | 5 | ||
| Training/information | Mean | 5.17 | 4.6 | 5 | 0.087 |
| Median | 5 | 5 | 5 | ||
| Time at work for revision | Mean | 5.41 | 4.57 | 5.16 | 0.033 |
| Median | 6 | 5 | 5 | ||
| Time after work for revision | Mean | 5.61 | 4.93 | 5.41 | 0.123 |
| Median | 6 | 5 | 6 | ||
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