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electrolyte replacement in icu

Repletion of electrolytes often depends on providerspecific behavior and hospital policy We examined the pattern of electrolyte repletion across several intensive care units ICU in a large

January 10,2020 by: Philip Pritt
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PDF Protocoldriven Vs Physiciandriven Electrolyte

Electrolyte Abnormalities Summary LITFL CCC Electrolytes

Intravenous piggyback infusions of electrolytes must be administered with freeflow protected infusion devices ie infusion pump Patients must meet the following criteria prior to initiation of the ICU Potassium Calcium Magnesium andor Phosphorus Replacement Protocols CrCl 45

ELECTROLYTE REPLACEMENT ICU REMINDER DO NOT USE on patients with DKA Refeeding syndrome receiving any form of dialysis or in emergency situations NURSING Notify Physician and call for replacement orders if Potassium level 25 mEqL Magnesium level 08 mgdL Phosphorus levels 11 mgdL Electrolyte Replacement Labs

Electrolyte Replacement Critical Care ICUPCU 30400716 PHYSICIAN ORDERS PATIENT INFORMATION Magnesium Replacement If serum creatinine over 2 mg dL andor Documentation of Renal failure or Dialysis contact MD for specific orders If multiple IV electrolytes to be replaced please consult pharmacist MAGNESIUM LEVEL 14 17 Single Response

2 mgdL or patients on any form of renal replacement therapy intermittent or continuous These guidelines are meant to assist with empiric dosing of electrolytes for ICU patients doses may need to be adjusted based on patientspecific factors and responses to initial doses

Potassium was chosen for the primary end point because it is the electrolyte for which repletion is most often performed in the ICU and potassium abnormalities are associated with worse outcomes than occur with abnormalities of other electrolytes

Significant electrolyte depletion can result in serious complications for patients Intravenous electrolyte replacement can produce lifethreatening complications serious arrhythmias and phlebitis therefore supplementation must be carefully monitored2 There are multiple underlying factors for electrolyte disorders in adult inpatients

3034 mgdL 6g CaGluconate 4 Hours After Replacement 2529 mgdL 8g CaGluconate 4 Hours After Replacement 25 mgdL 10 g CaGluconate NHO 4 Hours After Replacement Infuse 2gm per hour Approved Dr Addison K May MD FACS FCCM December 2013 Zaloga GP KR Bernards WC Layons AJ Fluids and Electrolytes

Interim LSU Public Hospital ADULT ELECTROLYTE REPLACEMENT PROTOCOL FOR USE IN ICUs ONLY PHOSPHATE If K less than or equal to 40 mEqL Normal range 25 47 mgdl Serum Phosphorus Replace with Recheck level less than 16 mgdl

Electrolyte imbalances are frequently encountered in the Intensive Care Unit ICU and protocoldriven interventions may facilitate more timely and uniform care Objective To compare the effectiveness and timeliness of electrolyte replacement in an adult ICU before and after implementation of an Electrolyte Replacement Protocol ERP and to

Repletion of electrolytes often depends on providerspecific behavior and hospital policy We examined the pattern of electrolyte repletion across several intensive care units ICU in a large

This retrospective study was conducted in the surgical intensive care unit ICU at the Centre hospitalier universitaire de Sherbrooke a 682bed tertiary care university hospital in Sherbrooke Quebec Until the end of 2006 electrolyte repletion for ICU patients was performed by medical staff during rounds or during patient visits

1 UNIVERSITY OF MICHIGAN HEALTHSYSTEM Adult Intensive Care Unit Electrolyte Dosing Guidelines WARNINGS AND PRECAUTIONS Patients with renal insufficiency are exempt from these guidelines eg serum creatinine 2 mgdL or patients on any form of renal replacement therapy intermittent or continuous

To evaluate the effects of electrolyte replacement protocol ERP implementation in the medical intensive care unit MICU setting We hypothesized that a protocol would reduce the time of replacement dose administration and increase provider satisfaction with the process of electrolyte replacement

The adult electrolyte infusion guidelines serve as suggested rates for intravenous electrolyte infusions Endorsed by the Pharmacy and Therapeutics Committee the guidelines include recommendations for patients in both ICU and nonICU settings Rates faster or slower than

PDF Protocoldriven vs physiciandriven electrolyte

Protocoldriven Vs Physiciandriven Electrolyte

Intravenous piggyback infusions of electrolytes must be administered with freeflow protected infusion devices ie infusion pump Patients must meet the following criteria prior to initiation of the ICU Potassium Calcium Magnesium andor Phosphorus Replacement Protocols CrCl 45ELECTROLYTE REPLACEMENT ICU REMINDER DO NOT USE on patients with DKA Refeeding syndrome receiving any form of dialysis or in emergency situations NURSING Notify Physician and call for replacement orders if Potassium level 25 mEqL Magnesium level 08 mgdL Phosphorus levels 11 mgdL Electrolyte Replacement LabsElectrolyte Replacement Critical Care ICUPCU 30400716 PHYSICIAN ORDERS PATIENT INFORMATION Magnesium Replacement If serum creatinine over 2 mg dL andor Documentation of Renal failure or Dialysis contact MD for specific orders If multiple IV electrolytes to be replaced please consult pharmacist MAGNESIUM LEVEL 14 17 Single Response2 mgdL or patients on any form of renal replacement therapy intermittent or continuous These guidelines are meant to assist with empiric dosing of electrolytes for ICU patients doses may need to be adjusted based on patientspecific factors and responses to initial dosesPotassium was chosen for the primary end point because it is the electrolyte for which repletion is most often performed in the ICU and potassium abnormalities are associated with worse outcomes than occur with abnormalities of other electrolytesSignificant electrolyte depletion can result in serious complications for patients Intravenous electrolyte replacement can produce lifethreatening complications serious arrhythmias and phlebitis therefore supplementation must be carefully monitored2 There are multiple underlying factors for electrolyte disorders in adult inpatients3034 mgdL 6g CaGluconate 4 Hours After Replacement 2529 mgdL 8g CaGluconate 4 Hours After Replacement 25 mgdL 10 g CaGluconate NHO 4 Hours After Replacement Infuse 2gm per hour Approved Dr Addison K May MD FACS FCCM December 2013 Zaloga GP KR Bernards WC Layons AJ Fluids and ElectrolytesInterim LSU Public Hospital ADULT ELECTROLYTE REPLACEMENT PROTOCOL FOR USE IN ICUs ONLY PHOSPHATE If K less than or equal to 40 mEqL Normal range 25 47 mgdl Serum Phosphorus Replace with Recheck level less than 16 mgdl

PDF Protocoldriven vs physiciandriven electrolyte

PDF FLUID AND ELECTROLYTES MANAGEMENT IN ICU

Intravenous piggyback infusions of electrolytes must be administered with freeflow protected infusion devices ie infusion pump Patients must meet the following criteria prior to initiation of the ICU Potassium Calcium Magnesium andor Phosphorus Replacement Protocols CrCl 45

ELECTROLYTE REPLACEMENT ICU REMINDER DO NOT USE on patients with DKA Refeeding syndrome receiving any form of dialysis or in emergency situations NURSING Notify Physician and call for replacement orders if Potassium level 25 mEqL Magnesium level 08 mgdL Phosphorus levels 11 mgdL Electrolyte Replacement Labs

Electrolyte Replacement Critical Care ICUPCU 30400716 PHYSICIAN ORDERS PATIENT INFORMATION Magnesium Replacement If serum creatinine over 2 mg dL andor Documentation of Renal failure or Dialysis contact MD for specific orders If multiple IV electrolytes to be replaced please consult pharmacist MAGNESIUM LEVEL 14 17 Single Response

2 mgdL or patients on any form of renal replacement therapy intermittent or continuous These guidelines are meant to assist with empiric dosing of electrolytes for ICU patients doses may need to be adjusted based on patientspecific factors and responses to initial doses

Potassium was chosen for the primary end point because it is the electrolyte for which repletion is most often performed in the ICU and potassium abnormalities are associated with worse outcomes than occur with abnormalities of other electrolytes

PDF Protocoldriven vs physiciandriven electrolyte

Teaching Files Critical Care Medicine Mcgill University

Intravenous piggyback infusions of electrolytes must be administered with freeflow protected infusion devices ie infusion pump Patients must meet the following criteria prior to initiation of the ICU Potassium Calcium Magnesium andor Phosphorus Replacement Protocols CrCl 45

ELECTROLYTE REPLACEMENT ICU REMINDER DO NOT USE on patients with DKA Refeeding syndrome receiving any form of dialysis or in emergency situations NURSING Notify Physician and call for replacement orders if Potassium level 25 mEqL Magnesium level 08 mgdL Phosphorus levels 11 mgdL Electrolyte Replacement Labs

Electrolyte Replacement Critical Care ICUPCU 30400716 PHYSICIAN ORDERS PATIENT INFORMATION Magnesium Replacement If serum creatinine over 2 mg dL andor Documentation of Renal failure or Dialysis contact MD for specific orders If multiple IV electrolytes to be replaced please consult pharmacist MAGNESIUM LEVEL 14 17 Single Response

2 mgdL or patients on any form of renal replacement therapy intermittent or continuous These guidelines are meant to assist with empiric dosing of electrolytes for ICU patients doses may need to be adjusted based on patientspecific factors and responses to initial doses

Potassium was chosen for the primary end point because it is the electrolyte for which repletion is most often performed in the ICU and potassium abnormalities are associated with worse outcomes than occur with abnormalities of other electrolytes

PDF Protocoldriven vs physiciandriven electrolyte

Kmag Replacement Protocol CCU Coronary Cardiac

Fluid and Electrolyte Management Billie Bartel and Elizabeth Gau Le a r n i n g Objectives 1 Identify and understand basic fluid and electrolyte abnormalities in critically ill patients 2 Differentiate between the types of fluids used for fluid replacement in different disease states commonly seen in the intensive care unit

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