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Guidelines for intravenous fluids in children published.

BEST PRACTICE guidelines on managing intravenous (IV) fluid balance in children have been published for the first time. The National Institute for Health and Care Excellence (NICE) guidelines promote a consistent approach to the provision of IV fluids to children in NHS hospitals. There are recommendations on assessment and monitoring, lost fluid replacement, managing high and low blood sodium levels, and using specific preparations depending on the clinical situation. Also included in the guidelines are algorithms to support clinical decision making and a diagram showing fluid loss in the body. Paediatric nurse practitioner at Noah’s Ark Children’s Hospital in Cardiff, Deborah Evans worked on the guidelines. She explained there is variation in specialities and hospitals about what types of fluids are being used, complications due to hyponatraemia (low sodium level), and issues with electrolyte balance monitoring. Ms Evans believes that, by providing evidence for good practice, the guidelines will give nurses confidence. She said: ‘Doctors do the prescribing, but nurses put drips up. Doctors can become defensive if challenged, but the guidelines will give them [nurses] the evidence they need. ‘I hope that nurses find the guidelines helpful. They offer more clarity about what they should look for and more backup if they are unhappy about what has been written.’ Inadequate monitoring of fluid and electrolyte levels can lead to low blood volume and poor blood flow through the organs, or too much fluid leading to fluid collection in the tissues and possible heart failure. Grant awarded for research into sexual health of homeless young people living in hostels