Normal Saline Flashcards

1
Q

Presentation

A
  • 10 ml polyamp

- 500 ml and 1000 ml infusion soft pack

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2
Q

Pharmacology

A

Isotonic crystalloid solution

Composition:
- Electrolytes (sodium and chloride in a similar concentration to that of extracellular fluid)

Action:
- Increases the volume of intravascular compartment

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3
Q

Metabolism

A

Electrolytes:
- excreted by the kidneys

Water

  • excreted by the kidneys
  • distributed throughout total body water, mainly in extracellular fluid compartment
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4
Q

Indications

A
  • replacement fluid in volume-depleted pt’s
  • cardiac arrest secondary to hypovolaemia or where the pt may be fluid responsive
  • expand intravascular volume in non-cardiac, non-hypovolaemic hypotensive pt eg: anaphylaxis, burns, sepsis
  • as a fluid challenge in unresponsive, non-hypovolaemic, hypotensive pt’s (other than LVF) eg: asthma
  • fluid for diluting and administering IV drugs
  • fluid TKVO for IV administration of emergency drugs
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5
Q

Contras

A

NIL of significance in the above indication

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6
Q

Precautions

A

Consider modifying factors when administering for hypovolaemia

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7
Q

Route of administration

A
  • IV

- IO

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8
Q

Side effects

A

NIL of significance in the above indication

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9
Q

IV half life

A

Approximately 30-60 mins

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10
Q

Haemorrhagic Hypovolaemia

A

BP > 70 mmHg

  • tolerate hypotension without fluid replacement for up to 2 hrs
  • consult if long prehospital times, prolonged extrication or elderly/frail pts

BP < 70 mmHg

  • 250 ml IV bolus
  • repeat 250 ml IV bolus as required
  • titrate to BP > 70 mmHg
  • max 2000 ml
  • consult if inadequate response
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11
Q

Cardiac arrest

A

In PEA arrest where hypovolaemia, anaphylaxis or asthma is suspected or the pt has a rhythm that my be fluid responsive
- 20 ml/kg IV

All cardiac arrest pt’s

  • TKVO IV
  • flush all medications with 20 - 30 ml
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12
Q

Anaphylaxis

A

Less than adequate perfusion

  • 40 ml/kg IV
  • titrated to pt response
  • consult for further fluid
  • if consult not available repeat 20 ml/kg IV
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13
Q

Inadequate perfusion (non-cardiogenic/non-hypovolaemic)

A

?

  • Sepsis
  • Chest is clear
  • MICA not available
  • 20 ml / kg IV over 30 mins
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14
Q

Nausea and Vomiting

A

Dehydrated with Less than adequate perfusion

  • 40 ml/kg IV
  • consult for more fluid
  • if consult unavailable 20 ml/kg IV
  • total max 60 ml/kg

Dehydrated with adequate perfusion
- 20 ml/kg IV over 30 mins

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15
Q

Burns

A

pt > 15 yrs with TBSA > 15%

  • NS IV @ % TBSA x pt weight (kg) = vol fluid (ml)
  • administer over 2 hrs from time of burn

pt 12 - 15 yrs with TBSA > 10%
- NS IV @ 3 x %TBSA x pt weight (kg) = vol fluid (ml)
- given over 24 hrs from time of burn
administer half of the 24 hr fluid volume over the first 8 hrs

pt < 12 yrs - MICA for fluid administration

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