We need guidelines to do better- An audit on intravenous fluid usage in a single paediatric unit.
Abstract
Objective: To observe the current practice of Intravenous Fluid ( IVF) in a paediatric unit in relation to indications, type, rate and practice of the monitoring process to identify complications.
Method: Bed Head Tickets (BHT) of all children who received IVF were analyzed retrospectively using a Performa, during a period of 3 months.
Results: During 3 months 163 children out of 986 patients received IVF. Among them there were 83 males. 95 (58%) were in the under 5 years age group. Commonest indication for IVF was poor oral intake while the next was significant vomiting. In 48 children no indication for IVF was mentioned. Proper clinical assessment records indicating the degree of dehydration was found only in 10 BHTs analyzed. Thirteen (08%) received 10ml/kg normal saline fluid boluses. Commonest fluid used as maintenance was N/2+5%dextrose. A hundred and three (63%) received IVF for more than 24 hours. But input, output charts were maintained only by 68%. Electrolytes and blood sugars were monitored in 90( 63% ). Interestingly, only complication recorded was fluid extravasation in seven BHTs.
Conclusion: In this unit IV fluid administration was done not according to any standard practice. New guidelines should be prepared to guide usage of IV fluids in paediatric patients.
