🎙️ Surgery - EP3: Fluid Balance and Replacement
Welcome to another episode of the MedSimu Surgery Podcast, where we break down surgical fundamentals for clinical excellence and exam prep. Today’s focus is fluid balance—a vital concept in both acute and routine surgical care.

🎧 Tune in to Learn:
✅ Fluid Compartments – ICF vs. ECF, and the 60/40/20 rule
✅ Monitoring – Clinical signs, urine output, daily weight, U&E
✅ Causes of Imbalance – Third spacing, surgery, kidney disease, iatrogenic errors
✅ Fluid Resuscitation – Shock criteria and emergency bolus strategy
✅ Maintenance Fluids – 25–30 mL/kg/day and the 100-50-20 rule explained
✅ Replacement Therapy – Calculating deficits, matching ongoing losses, adjusting for intake
✅ Electrolytes – Safe correction of sodium, potassium, and the role of labs

Chapters

• (00:00) - Intro & Overview
• (00:44) - What Is Fluid Balance?
• (01:06) - Fluid Compartments: ICF vs. ECF
• (01:28) - Electrolyte Movement & Homeostasis
• (01:38) - Why Monitoring Fluid Status Matters
• (02:16) - Signs of Dehydration & Overload
• (03:06) - Urine Output & Daily Weights
• (03:42) - Lab Investigations: U&Es, HCT
• (04:13) - Causes of Imbalance in Surgical Patients
• (05:14) - Emergency Resuscitation Criteria
• (05:39) - Fluid Bolus & Initial Steps
• (06:14) - Maintenance Therapy: When & How Much
• (06:44) - Maintenance Calculations: 100-50-20 Rule
• (07:15) - Fluid Replacement for Ongoing Losses
• (07:59) - Electrolyte Correction & Monitoring
• (08:19) - Final Recap & Takeaways

Whether you’re managing NBM patients, resuscitating trauma, or preparing for MRCS and surgical rotations, this episode will give you the clinical clarity you need.

🔔 Subscribe to the MedSimu Surgery Podcast for more essential breakdowns on surgical care!
#Surgery #FluidBalance #Electrolytes #MRCS #MedSimu #clinicalskills #medstudentpodcast

Welcome to another episode of the MedSimu Surgery Podcast, your essential audio companion for mastering surgical concepts and exam preparation. In this episode, we explore the structured approach to burn injury management, ideal for those preparing for MRCS, USMLE, PLAB, NEET-PG, or clinical practice.

✅ Initial Assessment – Trauma priorities, Rule of Nines, and estimating TBSA.
✅ Burn Pathophysiology – Systemic inflammatory response, capillary leak, Jackson's model.
✅ Fluid Resuscitation – Using and adjusting the Parkland formula based on patient response.
✅ Burn Depth Classification – Differentiating superficial, dermal, and full-thickness burns.
✅ Wound Care & Surgery – Dressing, escharotomy, and skin grafting options.
✅ Special Scenarios – Electrical, chemical, and circumferential burns.
✅ Long-Term Issues – Hypermetabolic state, contractures, rehab, and psychological care.

• (00:00) - Intro & Overview
• (00:16) - Importance of Early Burn Management
• (00:30) - Initial Assessment & Rule of Nines
• (01:44) - Burn Epidemiology & Causes
• (02:45) - Pathophysiology of Burns
• (04:40) - Systemic Impact & Burn Shock
• (05:40) - Diagnosis & Initial Investigations
• (07:00) - Burn Depth Classification
• (08:28) - Fluid Resuscitation & Parkland Formula
• (10:28) - Supportive Measures & Wound Care
• (12:23) - Burn Unit Referral Criteria
• (13:22) - Surgical Management of Burns
• (14:46) - Long-Term Complications & Rehabilitation
• (15:41) - Final Recap & Key Takeaways

Whether you’re learning the basics or reinforcing your understanding, this episode provides a high-yield, clinically focused framework to manage burn injuries effectively.

🔔 Subscribe for more focused discussions from the MedSimu Surgery Podcast!

#Surgery #Burns #Trauma #MRCS #MedSimu #medicalpodcast #burnmanagement

Tune into this episode to learn about Acute Pancreatitis, a sudden inflammation of the pancreas. Did you know it's a condition that can range from mild to life-threatening? We'll explore how it's classified into mild, moderately severe, and severe forms based on complications and organ dysfunction.

While 80% of cases are mild and most patients recover within 3-7 days with conservative treatment, we'll also discuss that mortality is around 7-10%, primarily due to organ failure or sepsis.

Discover the most common causes: Gallstones and Alcohol account for over 50% of cases. We'll also touch upon other potential causes using the GET SMASHED mnemonic, including trauma, steroids, mumps, autoimmune factors, scorpion stings, hyperlipidaemia, hypercalcaemia, ERCP, and certain drugs.

Learn about the fascinating pathophysiology, which involves the premature activation of pancreatic enzymes within the pancreas, leading to autodigestion and inflammation. This can cause significant fluid shifts and potentially lead to shock and multi-organ dysfunction.

We'll cover the clinical presentation, including the hallmark symptom of sudden, severe epigastric pain, often radiating to the back, alongside nausea and vomiting, abdominal tenderness, and even signs like Cullen's sign (umbilical discoloration) and Grey Turner's sign (flank discoloration) in more severe cases.

Find out how Acute Pancreatitis is diagnosed through elevated serum amylase or lipase (at least 3 times the normal limit) and imaging like ultrasound and CT scans. We'll also touch upon severity assessment using criteria like Glasgow, APACHE II, and Ranson scores.

Finally, we'll discuss the management strategies, from essential non-pharmacological interventions like IV fluids, oxygen support, and monitoring, to pharmacological approaches for pain relief and the use of IV antibiotics for infected necrosis. We'll also explain the role of surgical interventions like early ERCP in gallstone pancreatitis and cholecystectomy.

Understand the potential early complications such as ARDS, acute kidney injury, and necrotising pancreatitis, and late complications including pancreatic pseudocyst, chronic pancreatitis, and diabetes mellitus.

Tune in to get a comprehensive overview of this important medical condition directly from our source material!