Passive leg raise and fluid replacement protocol (To be run by the nurse in charge)

Protocol developed by Dr David Christmas at Princess Royal Hospital.

Attach LiDCOrapid to patient

Stroke volume response increase Perform passive leg raise - tilt bed Stroke volume response increase
<7% to 30° head down position for 2 mins >7%

Perform fluid challenge -

STOP FLUIDS 250mls fluid given within a 5 min

}
period maximum Maximum of 3 fluid challenges to be
given to a patient (750mls of saline)
if patient still fluid responsive then
call a doctor

Stoke volume response <10% Stroke volume response >10%

If patients cardiac output or stroke volume decreases by more than 10% then call a doctor before repeating protocol

Contraindications and warnings

• Protocol not to be used with any patients who have a central nervous system disease, including head Trauma and spinal Injuries.
• Maximum of 3 fluid challenges to be given to patient (750mls of saline) if patient is still fluid responsive then call a doctor