4–2 -1 hourly rule
First 10kg –4m/kg fluid
Second 10kg –2ml/kg fluid
Remaining body weight –1ml/kg
Example:
a 22kg child undergoes a dental rehabilitation surgery under general anesthesia. The last oral intake was 8 hours ago. Calculate the fluids necessary to cover the deficit:
1. First 10kg x 4ml = 40ml
2. Second 10kg x 2ml = 20ml
3. remaining body weight (2kg) x 1ml = 2ml
So there is a total of 62ml/hour, and with an 8 hour deficit:
62 x 8 = 496ml
Use this rule for fluid deficit, maintenance, and fluid loss during surgery.
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