Saudi Journal of Emergency Medicine

Original Article
SJEMed. 2020; 1(1): 20-24

Intravenous fluid therapy in the noncritically ill patient. Our experience at a tertiary care emergency department in Abu Dhabi

Authors: Bashar Elwir, Patrick Ukwade, Ayesha Almemari.

View PDF HTML Fulltext DOI: 10.24911/SJEMed/72-1573218676

Abstract

Background: Intravenous (IV) fluids are a commonly prescribed treatment in the emergency department (ED). Often the prescription of a treatment to be administered in the ED prolongs the patients' length of stay (LOS). We hypothesize that IV fluids are overprescribed in the ED, mainly in patients classified as Emergency Severity Index (ESI) triaged level 3 (T3) and level 4 (T4). Methods: We conducted a quality audit to assess the appropriateness of IV fluid use in adult (age > 16 years) hemodynamically (HD) stable ESI triaged T3 and T4 patients at a tertiary hospital ED during two 6-month periods. Appropriate use of IV fluids was defined from the published literature and our own clinical experience. The primary outcome looked at was the number of patients appropriately prescribed IV fluids before and after implementing a list of indications for IV fluid use in HD stable patients. Results: Analysis showed 62.8% of T3 triaged patients and 74.2% of T4 patients were inappropriately prescribed IV fluids before the implementation of our indication list. This compared similar to 63.6% of T3 triaged patients and 71.4 % of T4 triaged patients after implementation. Median LOS of patients who received IV fluids was 3.5 and 3 hours for T3 and T4 patients, respectively. Conclusion: The data obtained in this quality audit demonstrated no difference in the use of IV fluids before and after implementing a list of indications for fluid therapy in HD stable T3 and T4 patients in our ED. We believe that developing a structured education program for caregivers in addition to patient education may help improve utilization of IV fluid based on true clinical indication.

Keywords:   Intravenous fluid administration, emergency departments, triage, overcrowding, length of stay


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Intravenous fluid therapy in the noncritically ill patient. Our experience at a tertiary care emergency department in Abu Dhabi


Authors
Bashar Elwir
Mafraq Hospital, Abu Dhabi, United Arab Emirates
PubMed articlesGoogle scholar articles

Patrick Ukwade
Mafraq Hospital, Abu Dhabi, United Arab Emirates
PubMed articlesGoogle scholar articles

Ayesha Almemari
Mafraq Hospital, Abu Dhabi, United Arab Emirates
PubMed articlesGoogle scholar articles


Correspondence to:
. Ayesha Almemari, Mafraq Hospital, Abu Dhabi, United Arab Emirates; aalmemari@seh.ae

Publication history
Received 08 Nov 2019
Revised 02 Jan 2020
Accepted 19 Jan 2020
Published online 07 Feb 2020
Published in print 08 Feb 2020

How to cite this article

Pubmed Style

Elwir B, Ukwade P, Almemari A. Intravenous fluid therapy in the noncritically ill patient. Our experience at a tertiary care emergency department in Abu Dhabi. SJEMed. 2020; 1(1): 20-24. doi:10.24911/SJEMed/72-1573218676


Web Style

Elwir B, Ukwade P, Almemari A. Intravenous fluid therapy in the noncritically ill patient. Our experience at a tertiary care emergency department in Abu Dhabi. http://www.sjemed.com/?mno=72921 [Access: August 05, 2020]. doi:10.24911/SJEMed/72-1573218676


AMA (American Medical Association) Style

Elwir B, Ukwade P, Almemari A. Intravenous fluid therapy in the noncritically ill patient. Our experience at a tertiary care emergency department in Abu Dhabi. SJEMed. 2020; 1(1): 20-24. doi:10.24911/SJEMed/72-1573218676


Vancouver/ICMJE Style

Elwir B, Ukwade P, Almemari A. Intravenous fluid therapy in the noncritically ill patient. Our experience at a tertiary care emergency department in Abu Dhabi. SJEMed. (2020), [cited August 05, 2020]; 1(1): 20-24. doi:10.24911/SJEMed/72-1573218676


Harvard Style

Elwir, B., Ukwade, . P. & Almemari, . A. (2020) Intravenous fluid therapy in the noncritically ill patient. Our experience at a tertiary care emergency department in Abu Dhabi. SJEMed, 1 (1), 20-24. doi:10.24911/SJEMed/72-1573218676


Turabian Style

Elwir, Bashar, Patrick Ukwade, and Ayesha Almemari. 2020. Intravenous fluid therapy in the noncritically ill patient. Our experience at a tertiary care emergency department in Abu Dhabi. Saudi Journal of Emergency Medicine, 1 (1), 20-24. doi:10.24911/SJEMed/72-1573218676


Chicago Style

Elwir, Bashar, Patrick Ukwade, and Ayesha Almemari. "Intravenous fluid therapy in the noncritically ill patient. Our experience at a tertiary care emergency department in Abu Dhabi." Saudi Journal of Emergency Medicine 1 (2020), 20-24. doi:10.24911/SJEMed/72-1573218676


MLA (The Modern Language Association) Style

Elwir, Bashar, Patrick Ukwade, and Ayesha Almemari. "Intravenous fluid therapy in the noncritically ill patient. Our experience at a tertiary care emergency department in Abu Dhabi." Saudi Journal of Emergency Medicine 1.1 (2020), 20-24. Print. doi:10.24911/SJEMed/72-1573218676


APA (American Psychological Association) Style

Elwir, B., Ukwade, . P. & Almemari, . A. (2020) Intravenous fluid therapy in the noncritically ill patient. Our experience at a tertiary care emergency department in Abu Dhabi. Saudi Journal of Emergency Medicine, 1 (1), 20-24. doi:10.24911/SJEMed/72-1573218676


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