Normal Saline

Question 1

Normal Saline (0.9% solution soduim chloride, NS)

CLASS:

Answer 1

• Electrolyte / isotonic crystalloid

Question 2

Normal Saline (0.9% solution soduim chloride, NS)

ACTION

Answer 2

• Electrolyte solution that 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

Normal Saline (0.9% solution soduim chloride, NS)

INDICATIONS

Answer 3

Definitive Therapy: (P-104, S-101)

• immediate or anticipated immediate need for administratin of a fluid bolus or medications.

• Abdominal discomfort - GI/GU (Non-traumatic) (S-120) (S-174)

• ADULT & PEDS: suspected volume depletion
• ADULT: symptomatic ? aortic aneurysm to maintain BP at 80

• Anaphylaxis (S-122, S-162)

• ADULT: For BP <90
• PEDS: to maintain BO ≥ (70 + 2xage)

• Altered Neuro Function (S-123)

-ADULT: CVA to maintain BP ≥ 120

• Burns (S-124, S-170)

• ADULT: with D20% 2^nd oor ≥ 3^rd degree burns
• PEDS: with ≥ 10% 2^nd or ≥ 5% 3^rd degree burns

• Dysrhythmias (S-127, S-163)

• ADULT: see protocol
• PEDS: see protocol

• Enviormental exposure (S-130)

-ADULT: Heat exhaustion

• Overdose (S-134)

-ADULT: ?stimulant intoxication with excited delirium

• SHOCK (S-138, S-168)

• ADULT: see protocol
• PEDS: see protocol

• Crush injury with extended compression ≥ 2 hours (S-139, S-169)

-ADULT & PEDS: just prior to extremity being released

• Sepsis (S-143)

-ADULT: see protocol

• Respiratory Distress (S-136, S167)

-ADULT & PEDS: with croup like cough via nedulizer

• Trauma (S-139, S-169)

• ADULT: to maintain BP at 80
• PEDS: to maiintain BP ≥ (70 + 2X age)

Question 4

Normal Saline (0.9% solution soduim chloride, NS)

CONTRAINDICATIONS

Answer 4

• Rales (for fluid bolus)

Question 5

Normal Saline (0.9% solution soduim chloride, NS)

SIDE EFFECTS

Answer 5

• None

Question 6

Normal Saline (0.9% solution soduim chloride, NS)

SPECIAL INFORMATION:

Answer 6

1. BP goals:
   
   • 80 systolic in trauma and aortic aneurysm

120 systolic in stroke patients

90 systolic in all others

2. For MTV, IV is started in route
3. Be conservative in use of fluids with a suspected head injury patient to minimize the risk of developing cerebral edema. Judicial fluid use may be needed for hypotension associated with head injury to maintain cerebral perfusion (CPP=MAP-ICP)
4. Small bag (250ml) is used for patients with rales, significant HTN and ?intracrainal bleed.
5. Fluid boluses are at 500ml; a 250 bolus is used in cardiogenic shock. do not use either patients with rales. Reassess BP & lungsounds to determine if fluid overload may be developing.
6. Dose for pediatric patients are weight related (Generally 20ml/kg PDC)
7. Dose for burn patients are age related (500ml for adults, 250 ml for 5-14 y/o, 150ml for < 5 y/o.
8. Flow rates:
   
   • 18 ga catheter delivers 80 ml/min wide open maxi tubing
   • 14 ga catheter delivers 160 ml/min wide open maxi tubing
   • TKO is approximately
     
     • 5 gtts/min with maxi drip
     • 30 gtts/min with mini drip

Question 7

Normal Saline flow rate:

TKO

Answer 7

TKO is approximately

5 gtts/min with maxi drip
30 gtts/min with mini drip

Question 8

Normal Saline flow rate

CATHETER

Answer 8

18 ga catheter delivers 80 ml/min wide open maxi tubing
14 ga catheter delivers 160 ml/min wide open maxi tubing