INTAKE AND OUTPUT

Recording fluid intake and output is an important clinical care process that helps the medical responder determine the progress of the disease and the effects of the treatment. Recording of intake and output helps to ensure that the casualty has a proper intake of fluid. Recording of output helps to determine whether there is an adequate output of urine and normal defecation. Correct recording of fluid balance helps ensure safe and effective nursing care to identify abnormalities in casualty conditions, proper resuscitation response, and fluid maintenance requirements over time. Critical casualties will typically have a Foley catheter (in-dwelling catheter,[IDC]) placed and may be getting hourly fluids or blood, which need to be monitored on a more frequent basis. Input and output is typically recorded in cubic centimeters (cc) or milliliters (mL). If trying to estimate input or output without measuring tools, think of common items to help estimate fluid volumes. For example, a standard soda can contains about 350 cc.

Intake

- Oral, intravenous (IV), intraosseous (IO), via nasogastric (NG) or orogastric (OG) tube

Output

- Drainage from wounds, urine, and bowel movements

Frequency

- Non-critical casualties: Monitor and document throughout the day as intake and output occurs, totaling after 24 hours. (Non-medical and medical responders)
- Critical casualties: Monitor and document every 1-2 hours, making changes to IV fluids as needed. Total after 24 hours to determine overall fluid status. (Medical responders)

Equipment

- Minimum: Collect urine output in available container, such as an empty water bottle.
- Better: Graduated cylinder such as an empty IV fluid bag, fluid collection pan, urinary collection bottle, Nalgene bottle or similar container
- Best: Urinary catheter (if indicated based on casualty condition)