Core 4: Fluids & Electrolytes

Core 4: Fluids & Electrolytes

CORE CURRICULUM

Introduction

The Fluids and Electrolytes module seeks to introduce students to fluid assessment and prescribing in an inpatient setting. The curriculum will cover how to assess fluid status, the fluid balance, normal and corrective requirements for fluids and electrolytes and an introduction on how to start prescribing fluid and electrolyte therapy.

  • This module forms part of the Core Curriculum.
  • It requires some preparation.
  • It can be taught in approximately 90 minutes.

Teaching This Topic

As with all modules, first familiarise yourself with The 9 Rules of STITCCH.

It has been our impression that fluid prescribing remains one of the most important aspects of JMO practise which has not been taught successfully in medical school. It will not be uncommon for final year medical students to have no exposure to approach.

It is important in this session to to try and teach everything. Focus on basic approaches (such as assessing fluid status and simple approaches to fluid regimes) and make sure that the students have understood the concepts first.

Here are examples of concepts too advanced and not to be taught:

  • Overly prescriptive formulas for fluid/electrolyte replacement. Speak in general approaches and the benefits of regular review (such as reassessing fluid status/regular EUCs).
  • Fluid therapy (as opposed to say, fluid restrictions) for hypernatraemia/hyponatraemia.
  • In depth discussion of Magnesium/Calcium replacements (instead tell students to refer to local guidelines, which is what many junior doctors regularly do).

From our feedback, it is important to repeat key concepts and apply them generously. You cannot have enough examples, sample patients and sessions where they practice prescribing on fluid order charts. Use the above teaching methods liberally.

We repeat, get the basics down first. That is more than enough and will be sorely appreciated by your students.

STITCCH Resources

  • Curriculum Pack (11 Pages)
  • Student Handout (7 Pages) give at the end of the session.
  • Fluid Balance Chart (to be obtained from hospital)
  • Fluid Order Chart (to be obtained from hospital)
  • Bags of Fluid and PO Electrolytes (Slow K etc) (to be obtained from hospital).
    • By allowing students to handle fluids and electrolytes they can see first hand the therapeutics and engage more in the session.

Other Resources

  • NICE Guidelines (linkIntravenous fluid therapy in adults in hospital.

Update History

1st Edition, 16 June 2016
2nd Edition, 1 July 2016
3rd Edition, 11 August 2016
4th Edition, 17 September 2016
5th Edition, 6 October 2016

Image Credit

Bryan K YYZ via Flickr (link)

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