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In single-variable analysis, the administration of blood products, D5W or D10W, was also associated with a more prolonged stay, although this association was no longer significant in multivariable analysis.
This assumption urges, in addition to ultrasound guidance and neurostimulation, the need for incorporating the half-the-air setting to minimize local anesthetic systemic toxicity during lumbar plexus block [28, 29] because the volume consumed to hydrolocate the needle tip and to visualize the hypoechoic spread is D5W instead of local anesthetic .
With this in mind I developed a proactive protocol that I call BEPCOP, an acronym for "Barnes' Excellent Post Cesarean Oxytocin Pro tocol." This involves simply running a 500-mL bag of oxytocin (30 units in 500 mL of D5W) at a constant rate of 50 mL/hour, which provides 50 mU/min oxytocin over the first 10 hours postdelivery.
Several reports have demonstrated that the administration of traditional hypotonic saline (D5W 0.2%NS) caused hyponatraemia in 25% of hospitalized children with devastating consequences.2 The most serious complication of hyponatraemia is acute encephalopathy which leads to cerebral oedema and intracranial hypertension.
Unfortunately, during this time, the nurses failed to notice the infusion rate error or recognize that an infusion of plain D5W alone or an infusion rate of 200 mL/hour was unsafe for a six-year-old child.
In one of the two recently reported cases, a pharmacist incorrectly calculated an excessively high infusion rate of plain D5W to give to a girl after outpatient tonsillectomy and adenoidectomy.
To minimize the risk of dose-related adverse effects, a dilute solution of ketamine should be employed (dilute 100 mg/mL of ketamine with sufficient saline or D5W to yield a final concentration of 10 to 50 mg/mL).
It also includes compatibility of single drugs with D5W and/or NS.
The nurse administers a mannitolbicarbonate cocktail added to 800 ml of D5W. He/she should expect an increase in Mr.
Owens' preoperation report showed that the patient received an IV of D5W dextrose solution (a sugar-based solution).
A one-liter bag of "D5W" (hospital lingo for dextrose in water, the fluids ordered routinely as hydration for many patients) provides only 170 calories --and no vitamins or minerals.
Post-Pyloromyotomy Conventional Regimen Feeding Method NPO x 6 hours after surgery D5W 30 cc q2 hours x 2 1/2 strength formula/breast milk 30 cc q2 hours x 3 Full strength formula/breast milk 45 cc q2 hours x 2 Full strength formula/breast milk 60 cc q3 hours x 2 Full strength formula ad lib q4 hours or may breast feed If emesis, hold feeding for 2 hours, then resume feeds at previous step RN or CA feeds infant until 60 cc tolerated, then parents may feed infant Frequent burping recommended Discharge home once regimen tolerated without emesis Note.
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