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Described Practices for Assessing Fluid Resuscitation in Acute Hospital Care: A Qualitative Study
E Lloyd1, A Ignatowicz2, E Sapey3
1BSc, Warwick Medical School, University of Warwick, Warwick, UK.
Acute Medicine
|January 9, 2020
Summary
Acute physicians use varied methods to assess patients for fluid resuscitation, classifying them into screening, emergency, and formal types. The patient's condition significantly influences the assessment approach, highlighting a need for further research into decision-making processes.
Area of Science:
- Emergency Medicine
- Clinical Assessment
- Qualitative Research
Background:
- Fluid resuscitation is a critical intervention in acute and emergency medicine.
- The specific methods and processes for assessing the need for fluid resuscitation have not been previously studied.
Purpose of the Study:
- To explore and describe how acute physicians approach the assessment of patients requiring fluid resuscitation.
- To understand the variations in fluid assessment processes used by clinicians.
Main Methods:
- A qualitative study involving semi-structured interviews with 18 acute physicians of varying grades.
- Thematic analysis was used to code and analyze interview transcripts.
Main Results:
- Physicians described three subtypes of fluid assessment: screening, emergency, and formal.
- The determination of whether a patient was 'sick' was a primary factor in selecting the assessment type.
- Significant heterogeneity was observed in assessment procedures, especially concerning the use of patient history.
Conclusions:
- Acute physicians employ distinct, though heterogeneous, approaches to fluid assessment based on patient acuity.
- Further research is needed to clarify how gathered assessment information informs decisions regarding the indication for fluid resuscitation.
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