23rd February 2024

A 25 year old female presents to hospital with a 2-day history of lower abdominal pain, concentrated on the right-hand side.

A 25 year old female presents to hospital with a 2-day history of lower abdominal pain, concentrated on the right-hand side. This has worsened significantly over the past couple of hours requiring two 2.5mg doses of IV Morphine Sulphate to control. She has been vomiting frequently and has only been able to tolerate small sips of water for 48hrs. She experiences migraines and postural hypotension but has no other medical conditions. She has a severe allergy to Penicillin. The surgical team has reviewed the patient and suspect acute appendicitis. They plan to operate later that day. Her physical observations and blood test results are as follows:

HR 118 BP 87/54 Temp 37.7 RR 20 O2 saturations 98% on air

Bloods: Hb 90, WCC 10.2, Plts 401, Na 136, K 3.2, Ur 9.1, Creatinine 84, CRP 140

What fluids should be prescribed to this patient first?