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What IV Fluid Should You Administer at the Hospital When You Have a High Fever? Hello. Today, we will look into fluid therapy for patients with high fever, a prescription frequently seen in hospitals. When a patient is admitted to the emergency room or a ward with a fever of 39 degrees or higher, many people first assume, "They will probably get a fever-reducing injection first, right?" However, in reality, hospitals check the patient's dehydration and circulatory status before administering fever reducers. When a fever rises, our bodies sweat profusely to lower body temperature. During this process, fluids and electrolytes are lost together, leading to dehydration; in severe cases, this can cause blood pressure to drop or the pulse to accelerate. Therefore, hospitals often administer IV fluids along with fever reducers to replenish the insufficient fluids and electrolytes first. ────────────────────── So, which IV fluids are actually used most often in hospitals? First is 0.9% Normal Saline, or Physiological Saline, which is the most commonly used basic intravenous fluid in hospitals. Physiological saline is a solution composed of 0.9% Sodium Chloride, meaning sodium and chloride. It has an osmotic pressure similar to that of our body's blood, allowing it to rapidly supply fluids into the blood vessels. Therefore, it is often the first choice for patients who have become dehydrated due to high fever or have dropped blood pressure. It is also widely used as a basic fluid to dilute intravenous medications or to connect other fluids. Next is the infusion rate. For adult maintenance fluids, approximately 80–125 mL/hr is most commonly used. If dehydration is severe due to high fever, 250–500 mL may be administered rapidly over 30 minutes to an hour. In cases of significantly lowered blood pressure, 500–1,000 mL may be administered rapidly within 30 to 60 minutes. However, this rate may be ineffective in cases of heart failure or renal failure. Patients should administer at a low rate of approximately 30–60 mL/hr, or infuse more slowly as directed by a doctor. In hospitals, the following medications are often mixed with normal saline solution for administration: Denogan Injection, Acetaminophen Injection Some antibiotics (requires verification of diluents for each drug) Vitamin B and C preparations (follow hospital guidelines) However, there is something you must remember here. Not all medications can be mixed with normal saline solution. This is because the appropriate fluid for dilution varies for each drug, and whether mixing is possible also differs for each. You must check hospital guidelines or the product leaflet before mixing. Excessive administration of normal saline solution can cause swelling of the body or pulmonary edema (fluid accumulation in the lungs). Additionally, elevated sodium and chloride concentrations may lead to electrolyte imbalances or hyperchloric metabolic acidosis. Therefore, particular caution is required for patients with heart failure or renal failure. Precautions also There is Normal saline solution can cause pulmonary edema or peripheral edema if administered in excessive amounts, and carries a risk of hypernatremia and hyperchloric metabolic acidosis. Particular caution is required when administering it to patients with heart failure or renal failure, as their ability to regulate fluids and electrolytes is impaired. Therefore, for patients with underlying conditions, the dosage and administration rate must be closely monitored to prevent overdose. ────────────────────── The second is Lactated Ringer's Solution, or Hartmann Solution. This is Hartmann's solution, which is used very frequently in emergency rooms and wards. Unlike normal saline solution, it contains not only sodium but also potassium, calcium, chloride, and lactate. Because its composition is similar to the body's electrolytes, it is frequently used for patients with vomiting, diarrhea, or dehydration. Additionally, lactate is metabolized into bicarbonate in the liver, which helps alleviate acidosis. General Infusion Rate General maintenance fluids are administered at 80-125 mL/hr. For dehydrated patients, 250-500 mL is administered over 30 minutes to 1 hour. For post-operative or emergency patients, 500-1,000 mL may be administered rapidly depending on the condition. In patients with renal or heart failure, the dosage may be 50 mL/hr or less to prevent overdose. However, Hartmann's solution cannot be mixed with just any medication, unlike normal saline. Because it contains calcium, there is a risk of blood clotting if administered through the same line as blood products, and it cannot be used with certain medications. Even when mixing medications, compatibility must be verified according to hospital guidelines. There are also precautions. Although Hartmann's solution has an excellent electrolyte composition, it contains potassium, so there is a risk of causing hyperkalemi...