ANST - Dehydration

Lord Nikolai Piotr Danovich nikolai at fiac.net
Thu May 21 19:30:56 PDT 1998


>> with water, than pre-made stuff. But you are right, in an EMERGENCY
>> situation, salt water should be infused first, until the tissues are


I know I came in to this conversation late, but, my lady, an RN, has been
informing me that salt water could be dangerous to give, even in an
emergency situation.  The rest of this post is from her.

  Until an electrolyte panel is run, plain water should be given in case
this is a combined hypovolumic/hypernatremic (low fluid/high salt)
dehydration.  Dehydration is rarely a single cause process.  When it
becomes symptomatic, it is often a combination of problems.  

   If, by salt water (above) you are talking about 0.45% saline solution,
or, better yet, a 0.45% saline solution in 5% dextrose, I can fly with
that.  But for the average chirurgeon on the field, give water, if the
victim is alert (plain, cool water), and activate the local EMS.  It is
doubtful that a person could drink enough water to adversely affect his
sodium count, even if salt should be necessary, until proper medical care
could be given.

Note, in passing, on IV fluids:  Do NOT infuse a sodium solution of
Lactated Ringers to these types of dehydration patients.  The activity
(fighting) in which they have been participating will have already build up
free flowing lactic acid from their muscle tissue.  Extra lactate could
push these patients further into metabolic acidosis. <shudder>

Lady Elisabeth Erinn MacCabe

via Ld Nikolai

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