- Hyponatremia in patients who are symptomatic (e.g. seizures, coma) and have concentrated urine (osmolality of 200 mosm/L or greater)
- When high sodium and/or chloride content without large amounts of fluid is/are required (e.g. electrolyte and fluid loss replaced with sodium-free fluids, excessive water intake resulting in drastic dilution of body water, emergency treatment of severe salt depletion, addisonian crisis, diabetic coma).
- NaCl 3% injection available in 250 mL PVC minibags
- Store at room temperature
- No information
(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)
|IV Direct||YES, Central Line ONLY (can be given via PIV in emergency setting); Electrolyte and ICP monitoring
Infusion time: 5 minutes
|IV Intermittent Infusion||YES, Central Line ONLY (can be given via PIV in emergency setting); Electrolyte and ICP monitoring
Infusion rate: do not exceed 1 mmol/kg/hour
|IV Continuous Infusion||YES, Central Line ONLY (can be given via PIV in emergency setting); Electrolyte and ICP monitoring|
(For neonatal dosages, refer to Neonatal IV Drug Manual.)
- Intracranial Hypertension (ICU & Emergency)
- Bolus: 1-2 mL/kg/dose of 3% NaCl IV over 5 minutes q12h. An initial bolus of 2-4 mL/kg can be administered prn. Hold if serum osmolarity >305 mOsm/L
- Continuous Infusion: 0.1-1 mL/kg/hr of 3% NaCl administered on a sliding scale. The minimum dose needed to maintain ICP <20 mm Hg should be used.
-To correct acute, serious hyponatremia: mmol sodium = desired sodium (mmol/L) - actual sodium (mmol/L) x 0.6 x weight (kg)
SPOT TEAM to order, administer, and remain on floor for infusion & until serum sodium reported.
- Due to sodium excess: edema, pulmonary edema, hypertension, hyperchloremic acidosis, deep respiration, disorientation, nausea, weakness, potassium loss
- Local pain and venous irritation with a too rapid infusion
- Too rapid correction in sodium deficit can result in osmotic demyelination syndrome with resultant severe brain injury and potentially death
- Monitor serum sodium and chloride, ins and outs, weight
- 1 litre of NaCl 3% contains 513 mmol of sodium