   Nursing

## Calculating Maintenance Fluid Rates

Although it is the physicians’ responsibility to calculate and order daily fluid requirements for patients, Registered Nurses are responsible for double checking the order for accuracy. Below are two different methods used in calculating paediatric maintenance fluid rates. Nursing students at SickKids are expected to be familiar with these methods.

### Formula Method

(100 ml for each of the first 10kg) + ( 50ml for each kg 11-20) + (20 ml for each additional kg) / 24hour

Example:

 Calculate the hourly maintenance fluid rate for a child who weighs 25kg (100mL x 10kg) + (50mL x 10kg) + (20mL x 5kg) / 24hrs (1000mL) + (500mL) + (100mL) = 1600mL / 24hrs = 66.7ml/hr Using this formula the hourly fluid maintenance for this child is 67mL/hr

### 4 / 2 / 1 Method

(4ml/kg for the first 10kg) + (2ml/kg for kg 11-20) + (1ml/kg for every kg above 20) = hourly rate

Example:

 Calculate the hourly maintenance fluid rate for a child who weighs 25kg (4ml x 10kg) + (2ml x 10kg) + (1ml x 5kg) = hourly rate 40ml + 20ml + 5ml = 65ml/hr Using the 4/2/1 method, this child's hourly maintenance fluid rate is 65mL/hr 