Normal saline

Question 1

Normal saline - Type

Answer 1

Isotonic crystalloid solution of 0.9% sodium chloride solution. Contains 151mMol sodium and 151mMol chloride per litre

Question 2

Normal saline - Presentations

Answer 2

500 or 1000ml or 0.9% sodium chloride solution

Question 3

Normal saline - Actions (3)

Answer 3

1. Plasma volume expander
2. Also expands interstitial fluid volume
3. Plasma volume effect is only temporary as most of the saline moves out of the blood vessels quite quickly

Question 4

Normal saline - Uses (3)

Answer 4

1. Initial replacement of fluid, in volume depleted or dehydrated pts (volume depletion may be due to loss of blood, plasma or fluid and electrolytes)
2. Maintenance of hydration during prolonged pt contact time
3. TKVO, as IV route for drugs

Question 5

Normal saline - Adverse effect

Answer 5

Fluid overload

Question 6

Normal saline - Doses

Answer 6

Adult
 - in general to maintain sBP >90mmHg
      - give 250ml boluses, reassess after each bolus
 - Haemorrhagic hypovolaemia
      - 250ml boluses, max 20ml/kg
      - aim sBP 80-90mmHg
 - Traumatic brain injury
      - aim for sBP >100mmHg, no limit on amount
 - Sepsis or anaphylaxis
      - 20ml/kg, as req
 - TKVO
      - 10 dpm
Paediatric
 - 10ml/kg then reassess
 - Paediatric cardiac arrest
      - 20ml/kg
 - Sepsis and anaphylaxis
      - 20ml/kg
 - TKVO
      - 10 dpm