What's in IV Fluid Anyway?

It's 10 am... the most stressful time of the day for me during my internal medicine rotation... rounds. We round with 2 PAs and the attending. Rounds are the time when you give the team an oral report on your patients and all the relevant happenings since the last rounding session including med changes, reactions, vitals, Is and Os, eating and bowel habits, and the am physical exam findings - then you prioritize the problem list and come up with a plan. Sounds pretty straight forward until you throw a couple of patients with 13+ major diagnoses and over 25 medications each.

I must be a comical sight for the seasoned staff. I have about 25 note cards with chicken scratch from my morning routine, a notebook, and pockets full of pocket-sized manuals for the 2 patients that I am following. Meanwhile, they all walk around with a single piece of paper that contains all the notes for the 20 patients that they are each responsible for. Guess that's how the nurses spot a student from a mile away...

So anyway... the attending likes to frequently interrupt my oral reports with pimping questions, which only increases my stress level. One interesting question she asked was, "What are the electrolyte contents in normal saline, 1/2 NS, and D5W?" I hadn't the faintest idea. She informed me that she looked forward to me telling her the answer tomorrow. Hint, hint.

After rounds I visited the hospital pharmacy to ask if they had a list of all the IV fluids and their contents. My question elicited a laugh and a promise that they would "look around" for a list and page me when they found it. [That was 3 days ago. Still no page.] So I went home and hit up my pharmacy book. Nothing. CURRENT Medical. Nothing. Lange Critical Care Review. Nothing. Lange Surgery Review. Nothing. Fluids and Electrolytes Review. Nothing. Google, 4th page of results. Jackpot.

I didn't think it would be so difficult to find the content of IV fluids that we use on a daily basis! Almost all of the sources that I found explained how each solution was used - but I was just looking for a chart comparing the most-used IVFs... and then I found my golden ticket. I have listed the link to my handout below as well as some other resources I came across - hopefully they will come in handy for someone else.

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