Isotonic Crystalloid Fluids

Aliases: Normal Saline (0.9%), Lactated Ringer’s, or Plasma-Lyte 

Indications: Hypovolemia, Sepsis, Dehydration, Establishing vascular access and medication administration   

Contraindications: Fluid overload resulting in pulmonary edema and/or congestive heart failure 

Concentrations: 

Varies

Dosing

Adult:

Indication Dose Route Note 
-Hypovolemia
-Sepsis
-Dehydration
-Establishing vascular access
and medication
administration
10-20 mL/kg
(Max 2000mL)

May give in increments
of 250 to 1000 mL
boluses		IVMay titrate dose and
administration rate based
on assessment, MAP > 65
or permissive hypotension
when indicated, and most
appropriate clinical 
operating guideline 

Pediatric:

Indication Dose Route Note 
-Hypovolemia
-Sepsis
-Dehydration
-Establishing vascular access
and medication
administration
Pediatric: 20 ml/kg
boluses 
Newborn: 10 ml/kg
boluses 
IVMay titrate dose and
administration rate based
on assessment, mental
status and vital signs, and
most appropriate clinical
operating guideline 
Use Handtevy or Approved Pediatric Reference Guide for Amount to Administer

Precautions: None

Adverse/Side Effects: Crystalloid fluids are administered for volume expansion as indicated. Crystalloid fluids, such as Lactated Ringers or Normal Saline, do not add oxygen binding capacity. Rapid volume resuscitation of crystalloid fluids, preferably through large-bore line, may be indicated in the acute setting. Always monitor for signs of fluid overload and titrate to a desired effect. Maintenance infusion is indicated as needed to maintain patent access or minimum volume to maintain volume homeostasis.    

Class: Isotonic to human plasma    

Mechanism of Action: Approximate concentrations of various solutes and do not exert as osmotic effect, expand intravascular volume without disturbing ion concentration or significant fluid shift. 

Onset of ActionPeak EffectDuration of Action 
ImmediateVariesVaries