Normal Saline

Question 1

Normal Saline - what’s in the parenthesis

Answer 1

0.9% Solution Sodium Chloride, NS

Question 2

Class

Answer 2

Electrolyte/isotonic crystalloid

Question 3

Action

Answer 3

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

Question 4

Indications

Definitive Therapy:

Answer 4

• Immediate or anticipated immediate need for administration of a fluid bolus or medications

Question 5

Indications

Abdominal Discomfort - GI/GU (non-traumatic):

Answer 5

Adult and PEDS: suspected volume depletion

Adult: symptomatic suspected AAA to maintain BP at 80

Question 6

Indications

Anaphylaxis:

Answer 6

Adult: for BP < 90

PEDS: to maintain adequate perfusion

Question 7

Indications

Altered Neuro Function

Answer 7

Adult: CVA to maintain BP ≥ 120

Adult: Hyperglycemia

Question 8

Indications

Burns:

Answer 8

Adult: with ≥20% BSA partial thickness or ≥ 5% BSA full thickness

PEDS: with ≥10% BSA partial thickness or ≥ 5% BSA full thickness

Question 9

Indications

Discomfort/Pain of suspected Cardiac Origin:

Answer 9

• with associated shock

Question 10

Indications

Dysrhythmias:

Answer 10

Adult: see protocol

PEDS: see protocol

Question 11

Indications

Environmental Exposure

Answer 11

Adult: heat exhaustion

Question 12

Indications

Overdose:

Answer 12

Adult: ? Stimulant intoxication with excited delirium

Question 13

Indications

Shock:

Answer 13

Adult: see protocol

PEDS: see protocol

Question 14

Indications

Trauma:

Answer 14

Adults and PEDS: crush injury with extended compression ≥2 hrs

Adults: To maintain BP at 80

PEDS: to maintain adequate perfusion

Question 15

Indications

Sepsis:

Answer 15

Adult: see protocol

Question 16

Indications

Respiratory Distress:

Answer 16

Adult and PEDS: with croup-like cough via Nebulizer

Question 17

Contraindications

Answer 17

Rales (exception of sepsis)

Question 18

Side effects

Answer 18

None

Question 19

Special Information: PACS

Packaging

Answer 19

0.9% NaCl 1000ml or 250ml

Question 20

Special Information: PACS

Administration

Answer 20

• Dose for Pediatric patients are weight related (20ml/kg PDC)
• Dose for burn patients are age related (500ml adults, 250ml 5-14 y/o, 150ml < 5y/o)
• TKO is approximately
  - 5gtts/min with maxi-drip (10gtts = 1ml) tubing
  - 30gtts/min with mini-drip (60gtts = 1ml) tubing

Question 21

Special Information: PACS

Cautions and Considerations

Answer 21

• Consider small bag (250ml) for patients with rales, significant HTN, and suspected intracranial bleed
• Fluid blouses are at 500ml; a 250ml bolus is used in cardiogenic shock
• IV for MTV is started en route

Question 22

Special Information: PACS

Special Info:

Answer 22

BP goals

- 80 systolic for trauma and Aortic Aneurysm 
- 120 systolic for stroke patients
- 90 systolic for all others