.9% NaCI (Normal Saline, NSS)

Question 1

Classification

Answer 1

Isotonic crystalloid solution

Question 2

Mechanism of Action

Answer 2

• Provides Fluid & Electrolytes

Question 3

Indications

Answer 3

• Hypotension
• IV access & KVO for all patients
• Solution for mixing IVPB drug infusions

Question 4

Contraindications

Answer 4

• None in the emergency setting

Question 5

Adverse Effects

Answer 5

• Pulmonary Edema

Question 6

Administration

Answer 6

• KVO or 200-500 cc fluid bolus over 10-20 minutes as indicated
• Controllable hemorrhage or injury without shock:
  
  • 100-200 cc/hr (follow local protocol)
• ​Controllable hemorrhage with shock:
  
  • 10-20 cc/kg (follow local protocol)
• Uncontrollable hemorrhage with shock:
  
  • IV wide open until adequate signs of perfusion. ​(follow local protocols)
• Pediatric
  
  • ​20 cc/kg, IV or IO, repeat as needed.

Question 7

Notes & Precautions

Answer 7

• Normal Saline is a universal fluid and may be used in any medical or traumatic emergency.
• Although 10-20 cc/kg is the standard documented adult dose, continuous reassessment of the patient is mandatory. Reassess for signs of perfusion every 200-500 cc and adust the flow rate to support adequate perfusion.
• If hypotension is relieved with smaller amounts of fluid, slow the IV to 100-200 cc/hr. Do not continue with the 10-20 cc/kg infusion.
• Large volumes may result in hypothermia, especially in elderly patients.
• Fluid overload is always a concern.