Page 112 - 2023 SMOG Digital

Ringer’s, Lactate (Lactated Ringers/Hartman’s Solution)
Class: Isotonic crystalloid solution.
Mechanism of Action: Replaces water and electrolytes.
Indications: Hypovolemic shock; keep open IV.
Contraindications: Should not be used in the same line with blood components. Use with caution for
intravascular volume replacement for hemorrhagic shock due to hemodilution and exacerbation of
coagulopathy. Use with caution in patients with known congestive heart failure and kidney disease. Can
cause lactic acidosis.
Adverse Reactions: Rare
Drug Interactions: Few in the pre-hospital emergency setting.
How Supplied: 250mL, 500mL, and 1,000mL bags. IV infusion.
Dosage and Administration: Hypovolemic shock; titrate according to the patient’s physiologic response.
(See appropriate Guidelines)
Dextrose 5% in Water (D5W)
Class: Hypotonic dextrose-containing solution.
Mechanism of Action: D5W provides nutrients in the form of dextrose as well as free water.
Indications: IV diluent for certain emergency drugs; for dilution of concentrated drugs for intravenous
infusion.
Contraindications: Not for use as fluid replacement for hypovolemic states.
Adverse Reactions: Rare
Drug Interactions: Phenytoin (Dilantin)
How Supplied: Supplied in 50mL, 100mL, 150mL, 250mL, 500mL, and 1,000mL bags.
Dosage and Administration: Normally administered through a mini-drip (60gtt/mL) set at a rate of “to
keep open” (TKO).

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