Normal Saline

Question 1

Names

Answer 1

Normal Saline (0.9% Solution Sodium Chloride, NS)

Question 2

Class

Answer 2

Electrolyte / isotonic crystalloid

Question 3

Action

Answer 3

• 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 4

Definitive Therapy (S-104, S101)

Answer 4

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

IV / IO; Adjust PRN

Question 5

Abdominal Discomfort - GI/GU (non-traumatic) (S-120, S-174)

Answer 5

ADULT & PEDS: suspected volume depletion

ADULT: symptomatic suspected AAA to maintain BP at 80

Question 6

Anaphylaxis (S-122, S-162)

Answer 6

ADULT: for BP < 90
PEDS: to maintain adequate perfusion

Question 7

Altered Neuro Function (S-123)

Answer 7

ADULT: CVA to maintain BP ≥ 120
ADULT: Hyperglycemia

Question 8

Burns (S-124, S-170)

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

Discomfort / Pain of Suspected Cardiac Origin (S-126)

Answer 9

with associated shock

Question 10

Dysrhythmias (S-127, S-163)

Answer 10

ADULT: see protocol
PEDS: see protocol

Question 11

Environmental Exposure (S-130)

Answer 11

ADULT: heat exhaustion

Question 12

Overdose (S-134)

Answer 12

ADULT: ?stimulant intoxication with Excited Delirium

Question 13

Shock (S-138, S-168)

Answer 13

ADULT: see protocol
PEDS: see protocol

Question 14

Trauma (S-139, S-169)

Answer 14

ADULT & PEDS: crush injury with extended compression ≥ 2 hours
ADULT: to maintain BP at 80
PEDS: to maintain adequate perfusion

Question 15

Sepsis (S-143)

Answer 15

ADULT: see protocol

Question 16

Respiratory Distress (S-136, S-167)

Answer 16

ADULT & PEDS: with coup-like cough via NEBULIZER

Question 17

Contraindications

Answer 17

Rales (except for sepsis S-143)

Question 18

Side Effects

Answer 18

None

Question 19

Special Information: Packaging

Answer 19

0.9% NaCl: 1000ml or 250ml

Question 20

Special Information: Administration

Answer 20

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

Question 21

Cautions & Considerations

Answer 21

• Small bag (250ml) is used for patients with rales, significant HTN and suspected intracranial bleed
• Fluid boluses are at 500ml, a 250ml bolus is used in cardiogenic shock. Reassess lung sounds to determine if fluid overload may be developing.
• IV for MTV is started enroute

Question 22

Special Information

Answer 22

BP Goals:

1. 80 systolic in trauma and aortic aneurysm
2. 120 systolic in stroke patients
3. 90 systolic in all others