Blood, Electrolytes, and Intravenous Infusions
2-11
2-11. ABNORMAL FLUID LOSS
There are seven means of abnormal fluid loss from the body, and these are generally quite apparent to the individual. Vomiting and diarrhea are the most frequent and obvious.
a. Vomiting. A person who experiences severe vomiting not only loses the fluids taken orally, he also loses the gastric fluids (or juices) that are secreted into the stomach. These juices are rich in electrolytes. For example, a liter of gastric juice contains about 50 mEq of bicarbonate.
b. Diarrhea. Diarrhea (loose, watery stools) frequently accompanies vomiting when people have "bugs" or the "flu." Diarrhea is not only very uncomfortable and unpleasant, it accounts for a large loss of body fluids. A loss of electrolytes (sodium, potassium, chloride and others) is accompanied by the digested nutrients present in the diarrhea that is not absorbed by the body. For this reason, a severe bout of diarrhea is followed by general weakness.
c. Severe Perspiration. Severe perspiration that follows strenuous exercise in a hot environment can cause loss of electrolytes as well as heavy loss of fluid. Heat injuries can result.
d. Severe Burns. In very severe or widespread burns, the loss of protection by the skin allows body fluids to seep from the burned skin. This is a very serious effect of burns. The fluid and electrolytes must be replaced. Fluids and electrolytes can seep from the burns as fast as or faster than replacement fluids are administered.
e. Gastric Suction. Gastric suction of the stomach produces an effect similar to severe vomiting. Before long, the patient will lose a tremendous amount of electrolytes along with the fluids.
f. Bleeding. Bleeding of any amount produces loss of plasma, red blood cells, and other dissolved substances. The effect of the loss becomes greater as the amount of bleeding increases.
g. Diuretic Drugs. A person who is being treated with thiazide diuretics also loses fluids and electrolytes (primarily potassium). In such cases, potassium must be given to the patient to prevent potassium deficiencies.
