WREMAC MEMO
To: All Intermediate, AEMT, CC, and Paramedic WREAMC EMS Providers and Agencies
FROM: Brian Clemency DO, WREMAC Chair
DATE: August 12, 2014
RE: Normal Saline Shortage Guidance
Download WREMAC Saline Shortage Guidance Document
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The WREMAC Adult and Pediatric Advanced Life Support Protocols require the use of Normal Saline (.9% Sodium Chloride) when establishing any IV (trap, KVO, or volume replacement). Currently, Normal Saline packaging is available as a flush (10cc bolus for IV trap) but not in a form sufficient for volume replacement (500cc/1000cc bags).
Agencies without Normal Saline should review the guidance below and address specific concerns with their Medical Director.
The WREMAC has provided guidance to assist agencies and Medical Directors during the Normal Saline shortage, as follows:
- There is no change concerning the use of IV traps with a Normal Saline flush.
- An IV typically established “TKO” or “KVO” should, instead, be established utilizing an IV trap flushed with Normal Saline.
- Children and Adults (all patients > 1 year old) who may require volume replacement during EMS transport should receive Lactated Ringers as prescribed for Normal Saline in the WREMAC Protocols.
- EMS should contact medical direction for Infants (patients < 1 year old) who may require volume replacement during EMS transport.
Once Normal Saline becomes available in either a 500cc or 1000cc package, agencies shall immediately remove any Lactated Ringers supply and replace with Normal Saline.