Page 157 - 2026 SMOG

0.9% SODIUM CHLORIDE (NORMAL SALINE)
Class
• Isotonic crystalloid solution
Mechanism of Action
• Principal extracellular cation; functions in fluid and electrolyte balance, osmotic pressure
control, and water distribution.
Indications
• Hypovolemia, shock, heat-related injuries, Diabetic Ketoacidosis, TKO IV, a diluent of choice
for blood product transfusion.
Contraindications
• Avoid for intravascular volume replacement for hemorrhagic shock due to hemodilution and
hyperchloremic metabolic acidosis. Use with caution in patients with known congestive heart
failure.
Adverse Reactions
• Rare
Drug Interactions
• Few in the pre-hospital emergency setting.
Dosage and Administration
• The specific situation being treated will dictate the rate at which normal saline will be
administered. Hypovolemic shock requires a rapid bolus (see relevant guidelines). In other
cases, it is advisable to administer the fluid at a moderate rate (for example, 100mL/h).

2026 Standard Medical Operating Guidelines (SMOG) • 149