Page 111 - 2023 SMOG Digital

0.9% Sodium Chloride (Normal Saline)
Class: Isotonic crystalloid solution.
Mechanism of Action: Replaces water and electrolytes.
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.
How Supplied: 250mL, 500mL, and 1,000mL bags.
Dosage and Administration: The specific situation being treated will dictate the rate in which normal
saline will be administered. Hypovolemic shock requires rapid bolus (see relevant guidelines). In other
cases, it is advisable to administer the fluid at a moderate rate (for example, 100 mL/h).

Hypertonic Saline 3% Sodium Chloride
Class: Hypertonic crystalloid solution.
Mechanism of Action: Replaces water and electrolytes, increases intravascular sodium concentration,
may induce diuresis
Indications: Refractory elevated intracranial pressure (ICP) due to various etiologies (eg, subarachnoid
hemorrhage, neoplasm); traumatic brain injury with elevated ICP: (Can be used in place of mannitol).
Contraindications: Do not use in the same line as Blood Products – cause crenation and lysis of RBC.
Caution or avoid use in patients with known congestive heart failure and kidney disease.
Adverse Reactions: Rare
Drug Interactions: Few in the pre-hospital emergency setting.
How Supplied: 250mL, 500mL, bags.
Dosage and Administration:
• Dosing (Adult):
o Bolus: 250mL IV Bolus over 15 min
o Infusion: 50-100cc/hr
• Dosing (Pediatrics):
o Bolus: 5cc/kg IV Bolus over 15 min
o Infusion: 0.5cc/kg/hr

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