4 2 1 rule The 4 2 1 rule is a simplified method for estimating hourly maintenance fluid requirements in pediatric patients The 4 2 1 rule provides an alternative approach to the Holliday Segar formula which calculates daily fluid requirements
The maintenance fluids calculator MIVF calculator uses the Holliday Segar method and the 4 2 1 rule to determine the daily and hourly need for fluids in children As well as finding out these pediatric maintenance fluids you can also work out the proper size of the pediatric fluid bolus to be given in times of need In many cases a simple calculation called the 4 2 1 rule can determine the hourly rate of fluid maintenance required for a child based on their body weight 13 The formula outlined below illustrates its application where fluid maintenance rates are calculated based on the following criteria
4 2 1 rule
4 2 1 rule
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4 2 1 Rule Slidesharetrick
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4 2 1 Rule Slidesharetrick
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Instead of the 4 2 1 rule healthy children presenting with marginal to moderate hypovolemia e g fasting for surgery should be administered 20 40 mL kg of isotonic fluids during the surgery and postanesthesia care unit Maintenance Fluids Calculations MDCalc is utilized by millions of clinicians to treat hundreds of millions of patients worldwide
Calculate hourly maintenance fluid rates using standard weight based formula 4 2 1 rule Do not use maintenance IV fluids at rates above calculated maintenance and calculate replacement for ongoing fluid losses separately from maintenance In patients older than 28 days who do not meet exclusion criteria use The 4 2 1 rule 4 ml kg for first 10kg 2ml kg for the next 10kg 1 ml kg for every 1kg over 20 For example for a 70kg person 4 10 40 2 10 20 1 50 50 Total 110 ml hr This online calculator seems to use this rule mdcalc maintenance fluids
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IV Fluid Therapy First 1 10 kg 4 mL kg hr Next 11 20 kg 2 mL kg hr Next 20 kg 1 mL kg hr Add together for maintenance rate Calculation example BSA method BSA m2 1600 mL m2 day Daily requirement Maximum Rate 100 mL hr is an appropriate maximum rate in most patients The widely used formula for calculating this rate the 4 2 1 rule was developed in 1957 and was popularized as much for simplicity as for accuracy Its original proponents utilized a rough estimate of patient energy requirements to extrapolate fluid needs escalating stepwise with increases in weight to arrive at the 4 2 1
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4 2 1 rule - Calculate hourly maintenance fluid rates using standard weight based formula 4 2 1 rule Do not use maintenance IV fluids at rates above calculated maintenance and calculate replacement for ongoing fluid losses separately from maintenance In patients older than 28 days who do not meet exclusion criteria use