Saline bolus for high HR?

[SimplisticRnx]

I had a patient yesterday who had a regular BP but HR of 180's when standing up. Did orthostatic BP on the patient. Doctor order 1 liter of NS Bolus for 4 hours. Can someone explain the reasoning behind it? I know that NS bolus are common for those with low BP, but I don't get the picture about using it for elevated HR.

[Guest343211]

Right. Generally the first line is to treat the cause or possible cause--i.e., dehydration. Of course this is done more carefully in a baby, child, or person with certain cardiac dysfunction or someother issue that could render a problem.

He's following standard protocol. As a surgical recovery ICU nurse of children and adults, over all, I usually prefer colloids; but it really depends on the particulars.

If you dropped a PA catheter into this person (which you won't on the face value of this case), you may well see that the patient's CVP was low and systematic vascular resistance was very high. This is is indicative of low vascular fluid volume. In an attempt to increase blood flow, the basic calculation noted above, HR * SV = CO, demonstrates the body's response to low volume and thus to increase cardiac output by increasing the HR.

corrected. meant to write cvp low and svri high.