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Four and a fifth and all that
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This issue of the British Journal of Anaesthesia sees the publication of a survey.1 This, in itself, is fairly unusual, as few surveys of clinical practice reach publication. Way and colleagues relate how consultant anaesthetists prescribe perioperative fluids for children undergoing surgery. Whatever the limitations of surveys as scientific enquiry, as a snapshot of present practice, this paper is interesting. For one thing, it would seem to say that, at their own estimation, a quarter of consultants anaesthetizing children do so without having received any particular training for this purpose.
Nearly 50 yr ago, before the word acquired the niceties of present usage, Holliday and Segar came up with guidelines for maintenance fluids for children receiving i.v. therapy. Their figures for the volume of fluid required were derived from consideration of the child's energy expenditure. The sodium content of the fluid was decided from work which had looked at urinary
Liverpool, UK
E-mail: Mary.cunliffe@rlc.nhs.uk
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