Normal Saline Flashcards
What are the presentations?
Normal saline (NaCl 0.9%) in 1000ml soft plastic bag Normal saline (NaCl 0.9%) in 250ml soft plastic bag 10 ml plastic vial
What is it?
A sterile isotonic crystalloid solution
What are the indications?
Fluid replacement (volume expansion) for the treatment of shock, fluid loss, and cardiac arrest.
What are the contraindications?
Severe Pulmonary Oedema
What are the precautions?
Which patient presentations should be given IV fluids under strict monitoring?
Adult patients with penetrating trauma, ectopic pregnancy or aortic aneurysm with hypotension and signs of impaired organ perfusion may benefit from permissive hypotension (systolic blood pressure of 70mmHg)
How much fluid should you give to a patient presenting with shock, DKA or HHS?
How much for a small or elderly adult?
How much for a paed?
Adult: 250ml boluses to a maximum total of 2000ml
Small adult/elderly: 250ml boluses up to maximum total of 1000ml
Paediatric: 10ml/kg over 5-10 minutes. Repeat once only
What are the doses for TKVO?
20 drops per minute (20 drops = 1ml)
How much fluid should you give to an adult in cardiac arrest?
How much for a paed?
How much for a newborn?
Adult / Paediatric: 20ml/kg bolus as a reversible cause of hypovolaemia
Newborn: 10ml/kg as a reversible cause of hypovolaemia
How much fluid should you give to an adult post ROSC?
How much to a paed?
Adult: 250ml boluses to a maximum total of 500ml with reassessment between each infusion
Paediatric: 10ml/kg, repeat once only with reassessment between each infusion (bolus max. 250ml)
What are the doses for burns?
Adult: 1 litre stat, followed by 1 litre over 1 hour for TBSA >25% (Max. 2 litres)
1 litre over 1 hour for TBSA 15%-25% and 30 minutes transport time (Max. 1 litre)
Paediatric: 10ml/kg over 1 hour for TBSA > 10% and 30 minutes transport time
How much fluid should you give an adult for major haemorrhage?
How much for a paed?
Adult: Infuse 250ml boluses maximum total 2000ml with reassessment between each infusion
Paediatric: 10ml/kg (max. 250ml bolus) reassessment between each bolus (4x infusions maximum) to a total infusion not exceeding 1000ml. Only if patient presents with hypotension.
Special considerations?
Hypervolemia
