Intravenous fluid resuscitation

Poisoning can cause multiple circulatory disturbances due to vasodilation and negative inotropic effects; these include hypotension, abnormal cardiac conduction, arrhythmias and abnormal cardiac contractility.

First-line therapy for hypotension due to poisoning is intravenous fluid resuscitation. For adults and children with hypotension, use:

sodium chloride 0.9% (or other crystalloid solution1) 10 to 20 mL/kg intravenously, over 10 to 30 minutes. Repeat the dose if the blood pressure response is inadequate. Maximum total volume is 40 mL/kg up to 2000 mL. resuscitation for poisonings - IV fluid resuscitation

If a patient is elderly, frail, or has heart or kidney failure, use the lower end of the recommended dose range.

An appropriate response to intravenous fluid resuscitation is improvement in blood pressure and heart rate. If hypotension persists despite intravenous fluid resuscitation, inotropic support may be required.

1 Other crystalloid solutions include: glucose 5%, compound sodium lactate (Hartmann solution), sodium chloride 0.45% plus glucose 5%.Return