NORMAL SALINE (0.9% SOLUTION SODIUM CHLORIDE, NS)

- definitive therapy, or anticipated

ADULTS and PEDS:

- IV/IO SO; adjust prn

- shock: hypovolemia (S-138, S-139)

- shock (normovolemic: anaphylactic, neurogenic, septic) (S-138, S-168)

- anaphylaxis (S-122, S-162)

ADULT:

- IV/IO 500 ml blous; MR to maintain BP 90 systolic

PEDS "non cardiogenic":

- IV/IO PDC; MR if lungs are clear

- abdominal discomfort- GI/GU (nontraumatic) (S-120 adult)

ADULT:

- IV/IO 500 ml bolus for systolic BP <90

- shock ?cardiac origin (S-126, S-138, S-168)

- dysrhythmias (S-127)

ADULT:

- IV/IO bolus to max 250 ml with clear lungs; MR to maintain BP 90 systolic

PEDS "cardiogenic":

- IV/IO PDC with clear lungs; MR to maintain BP ≥[70+(2x age)]

- crush injury of extremity or torso with extended entrapment ≥2 hours (S-139,

S-169)

ADULT:

- IV/IO 500 ml blous just prior to extremity release; then TKO

PEDS:

- IV PDC just prior to extremity release BHO

- burn pts with ≥20% 2nd degree or ≥5% 3rd degree (s-124, S-170)

ADULT:

- ≥15 yo= IV/IO 500 ml bolus then TKO

PEDS:

- 5-14 yo= IV 250 ml bolus then TKO

  <5 yo= IV 150 ml bolus then TKO

- resp distress with croup like cough (S-136, S-167)

ADULTS and PEDS:

- 5ml via nebulizer

- symptomatic ? stimulant intoxication with sudden hypoventilation, oxygen desaturation or apnea (S-134)

ADULT:

- IV 500ml bolus; MR BHO

1. content of the 0.9% solution:

    - 154 mEq Na per liter

    - 154 mEq Cl per liter

2. be conservative in use of fluids with suspected head injury pt to minimize the risk of developing cerebral edema. judicious fluid use may be needed for hypotension associated with head injury to maintain cerebral perfusion. [CPP= MAP-ICP]

3. check BP and lung sounds to determine if fluid overload may be developing

4. burn dose is age related so actual amounts are listed

5. small bag (250ml) is always used for pts with rales

6. flow rates:

    - 18 ga catheter delivers 80ml/min wide-open (maxi tubing)

    - 14 ga catheter delivers 160ml/min wide-open (maxi tubing)

7. TKO is approximately:

    - 5gtts/min with maxi drip (10gtt= 1ml) tubing

    - 30gtt/min with min drip (60gtt= 1ml) tubing