Normal Saline

Question 1

Class

Answer 1

Electrolyte/ Isotonic crystalloid

Question 2

Action

Answer 2

• Electrolyte solution, which is osmotically equivalent to blood
• Increases the circulating volume of the vascular system (2/3 of infused volume leaves vascular space within 1 hour)

Question 3

Indications

Answer 3

Definitive Therapy
-immediate or anticipated immediate need for administration of a fluid bolus or medications
Abdominal Discomfort GI/GU (non traumatic)
-ADULT/PEDS: suspected volume depletion
-ADULT: symptomatic suspected AAA to maintain BP @ 80
Anaphylaxis
-ADULT: for BP/= 70 + (2x age)
Altered Neuro Function
-ADULT: CVA to maintain BP >/= 120
-ADULT: Hyperglycemia
Burns
-ADULT
-PEDS
Discomfort/Pain of suspected cardiac origin
-ADULT: with associated shock
Dysrhythmia
-ADULT/PEDS: see protocol
Environmental Exposure
-ADULT: heat exhaustion
Overdose
-ADULT: ?stimulant intoxication with excited delirium
Shock
-ADULT/PEDS: see protocol
Trauma:
-Crush injury with extended compression >/= 2 hours
-ADULT: to maintain BP @ 80
-PEDS: to maintain BP >/= 70 + (2x age)
Sepsis:
-See protocol
Respiratory Distress
-ADULT/PEDS: with croup like cough via Nebulizer

Question 4

Contraindications

Answer 4

Rales (exception for sepsis)

Question 5

Side Effects

Answer 5

None

Question 6

Special Information

Answer 6

Concentration: (0.9% NaCl) 1000ml or 250ml

1. BP Goals
   - 80 Systolic in trauma and aortic aneurysm
   - 120 Systolic in stroke patients
   - 90 Systolic in all others
2. IV for MTV is started en route
3. Small bag (250 ml) is used in patients with rales, significant HTN, and suspected intracranial bleed
4. Fluid boluses are @ 500ml. A 250ml fluid bolus is used in cardiogenic shock. Reassess lung sounds to determine if fluid overload may be developing
5. Doses for PEDS are weight related (20ml/kg PDC)
6. Doses for BURN patients are AGE related: Adults- 500ml, 5 to 14- 250ml,

Question 7

Flow Rates

Answer 7

18 ga catheter delivers 80ml/min, wide-open (maxi tubing)
14 ga catheter delivers 160ml/min wide-open (maxi tubing)

TKO is approx.
5gtts/min with maxi-drip tubing (10gtts=1ml)
30gtts/min with micro-drip tubing (60gtts=1ml)

Question 8

Normal Saline

Answer 8

0.9% solution sodium chloride, NS