ICUs Convert to Starbuck Sizes for Fluid Management

In an effort to stay current with a younger generation of doctors and nurses, the American Association of Critical Care Medicine (AACCM) has altered their guidelines to use “Starbucks” sizes for fluid management. Terms such as Tall, Grande, and Venti will now be encouraged when ordering fluids such as normal saline or lactated ringers.

To stay in line with the current Surviving Sepsis Guidelines, patients who present with septic shock will be recommended to be bolused “ 3 Venti size boluses of saline.” This amount is in-line with current recommendations of 20ml/kg. For patients on continuous fluids, instead of standards amounts of 75ml/hr or 100ml/hr, the AACCM is recommending using “one Tall NS per hour” or “one Grande LR per hour.”

To further stay in line with Starbucks designations, “amps” of bicarbonate will now be designated as “shots” of bicarb. For patients in renal failure, instead of ordering ½ NS with 2 amps of bicarbonate at 100mL/hr, the new recommendation will be “1 shots of bicarb in a half-caf Grande Latte per hour.”

Dr. Jamison Kinley, Director of Critical Care at Fairfield Regional Hospital in Connecticut, is excited for these new designations. Older doctors like me struggled when we went from “cc’s” to “mL’s” but we ultimately adapted. I think the new AACCM recommendations will be welcomed by my younger colleagues. Dr. Kinley is hoping his hospital’s IT department will have mobile ordering soon. Holiday Saline bags will be available this month.