SODIUM CHLORIDE 0.9% (NORMAL SALINE)

SODIUM CHLORIDE 0.9% (NORMAL SALINE)

SODIUM CHLORIDE 0.9% (NORMAL SALINE)
Class
	Isotonic electrolyte.
Action
	Fluid and sodium replacement.
Indications
	Heat related conditions Dehydration or hypovolemia Cardiopulmonary resuscitation and shock Diabetic ketoacidosis Keep vein open
Contraindications
	High doses in the presence of congestive heart failure.
Precaution
	Electrolyte depletion can occur following large amounts of normal saline. Should be used with great care, if at all, in patients with congestive heart failure, and severe renal insufficiency.
Side effects
	Thirst. Shortness of breath Joint pain, fever, rash.
Administration
Rout: IV/IO	Onset: Immediate	Peak effect: N/A	Duration: variable
Adult Dose:
	Hypovolemic shock & dehydration: 1000 ml IV bolus. Repeat dose and or titrate as needed to target hemodynamic stability. Septic shock: 30 mL/kg IV or more within the first 3 hours of resuscitation Cardiogenic shock: 250 mL IV bolus in patients without evidence of fluid overload. Repeat dose and/or titrate as needed to target hemodynamic stability. Diabetic ketoacidosis: 15 to 20 mL/kg (or 1,000 to 1,500 mL) IV during the first hour of treatment, then 250 to 500 mL/hour continuous IV infusion.
Pediatric Dose:
	Hypovolemic or distributive shock: 20 mL/kg IV bolus (Usual Max: 1,000 mL/bolus) over 5 to 20 minutes Cardiogenic shock: 5 to 10 mL/kg IV bolus over 10 to 20 minutes. Carefully monitor for signs of worsening respiratory status and pulmonary edema. May repeat as needed to restore blood pressure and tissue perfusion. Diabetic ketoacidosis: 10 to 20 mL/kg IV bolus (Usual Max: 1,000 mL/bolus) over 1 hour. Thereafter, therapy should be guided by hemodynamic status and serum electrolytes. Neonates: 10 mL/kg IV bolus. Administer over 5 to 10 minutes for near-term neonates; slower administration is recommended for neonates younger than 30 weeks’ gestation. May repeat once if significant improvement does not occur.