Fluid Resuscitation

See also 3.1.1 Hypotension

Those patients with significant toxicity or who receive decontamination require intravenous fluids for a number of reasons.

• It is useful to have intravenous access if significant clinical complications develop.
• These patients often have relative volume depletion, either due to the co-ingestion of alcohol or due to vasodilatation induced by ingested drugs.
• Patients who have received activated charcoal containing sorbitol will generally lose fluid into their bowel.

Therefore, most patients should have a litre of normal saline in the first hour and a further litre over the next three to four hours. Patients who are dehydrated or who have taken vasodilating or negatively chronotropic drugs will usually need even more fluid.