NHS patients on drips left dehydrated, says Nice

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Hospital patients' lives are being put at risk by NHS staff's poor attention to intravenous fluid care, experts say.

The National Institute for Health and Care Excellence says staff are either too overstretched or undertrained to provide for patients who are seriously dehydrated and need to be on a drip.

It is launching draft guidelines to remedy this.

A confidential inquiry found many patients received either too little or too much fluid, which can be fatal.

Basic care

Data gathered by the National Confidential Enquiry into Perioperative Deaths (NCEPOD) suggests as many as one in five patients on intravenous (IV) fluids have complications or die because of inappropriate administration.

The NCEPOD says inexperienced junior doctors are being left to provide care.

The National Institute for Health and Care Excellence (NICE) says as well as a lack of training in IV fluid management, professionals may be overworked and unable to give patients the attention they need.

And experts often disagree on which IV fluids are best, leading to wide variation in practice.

Prof Mark Baker, director of the Centre for Clinical Practice at NICE, said: "Current pressures on the NHS and the people who work within it can mean staff without the right knowledge or training are sometimes left to look after people who may need intravenous fluid therapy - when fluids must be administered through a drip.

"Making sure someone has the right level of fluid in their body is fundamental to good, basic care but this isn't always happening. There can be serious consequences if the wrong amount or composition of IV fluids is prescribed."

If a person receives too much or too little fluid this can lead to problems such as fluid in the lungs, dangerously raised or lowered levels of potassium, sodium or nutrients such as glucose, and in some cases, heart failure.

NCEPOD chief executive Dr Marisa Mason said: "NCEPOD welcomes the new guideline on fluid management, which has addressed the concerns that we have highlighted in several of our reports during the last 10 years.

"The NICE single guideline is a positive move that will support healthcare staff provide good quality care to patients in need of intravenous fluid therapy."