MLK / FLK CRI

Loading doses:
Morphine: 0.5mg/kg IM
Lidocaine: 1 mg/kg IV
Ketamine: 0.25 – 0.50 mg/kg IV

CRI in a bag:
Morphine (15 mg/ml) 8ml/L
Lidocaine (20 mg/ml ) 50ml/L
Ketamine (100 mg/ml ) 1.2ml/L
@ 1ml/kg/hr
=
Morphine 2 ug/kg/min or 0.12 mg/kg/hr
Lidocaine 17 ug/kg/min or 1.0 mg/kg/hr
Ketamine 2 ug/kg/min or 0.12 mg/kg/hr

Can go up to 3ml/kg/hr without exceeding any dose ranges

Cats – until more data is obtained, lidocaine’s use in cats cannot be recommended due to potential toxicity issues. If it is used in cats, do not exceed 10 ug/kg/minute, and monitor carefully for seizure activity and cardiac abnormalities (bradycardia).

CATS – LIDOCAINE (20 mg/ml): 300 mg/500 ml diluent = 15 ml/500 ml diluent = 30 ml/1000 ml diluent
Deliver at 1ml/kg/hr fluid rate = 10 ug/kg/min or 0.6 mg/kg/hr

To substitute fentanyl for morphine at a dose equipotent to the morphine dose above add:
FENTANYL (0.05 mg/ml): 0.6 mg/500 ml = 12 ml/500 ml diluent = 24 ml/1000 ml diluent.
Deliver at 1ml/kg/hr fluid rate = 0.02 ug/kg/min or 0.0012 mg/kg/hr

Source: http://www.vasg.org/constant_rate_infusions.htm

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Fluid Losses

  • Insensible losses (respiratory) = 22 – 33 ml/k/day (0.9 – 1.3 ml/kg/hr)
    Sensible losses (Urinary) =26 – 44 ml/kg/day (1 – 1.8 ml/kg/hr)
    Total maintenance = 44 – 99 ml/kg/day (1.9 – 3.1 ml/kg/hr)
    Average = 2.5ml/kg/hr
  • Insensible loss is almost pure water (hypotonic fluid loss)
    Sensible loss is an isotonic fluid loss
  • Vomiting, diarrhea, osmotic diuresis are all isotonic losses
    Diabetes insipidus, panting, water deprivation are hypotonic losses
    Addison’s disease is a hypertonic loss

Fluid Compartments

Total body water = 60% of body weight
Intracellular water = 40% of body weight
Extracellular water = 20% of body weight
Interstitial water = 16% of body weight
Plasma water = 4% of body weight

Intravascular volume = 7% of body weight (plasma volume + RBC volume)
Hematocrit = 3% (RBC volume) / 7% (intravascular volume) = 43%
Note that IV volume is part extracellular and part intracellular

Still-Life with Dryer

Still life with dryer
Still life with dryer

The much-awaited exhibit entitled “When Major Appliances Attack” opened today at the Center for Specialized Artistic Exploration. The exhibit features important works from renowned artist Malerie Vailman. Vailman appeared at the opening this morning surrounded by her entourage of body guards and agents. She arrived accompanied by her trendy beau known to the public only as Revin. Vailman, who stunned the artistic community in October with “Still Life with Dryer” has become one of the nations best-known new artists. Vailman is a founding member of the Paris-based Au-Pliance school. The 30-year-old artist says that this piece, “Reinvigorates the idea that art can be both beautiful and also a burned out dryer.” Most of the other, lesser-known artists on hand were locals struggling to break into the scene. Losh Jachowicz, a new immigrant from Poland, was very active in that country’s Vhirlpulvitz and Maytäg movements. Jachowicz was at the show to discuss his new, controversial piece entitled, “Nude: Refridgerated.” When asked to comment on his body of work, Jachowicz said, “I wish people could learn to see past my body.” … Touché Jachowicz.