Hypertonic Saline bolus

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Joel W Daniel
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Joined: 01/25/2018 - 09:33
Hypertonic Saline bolus

Inviting insights on you scoped bolus doses of hypertonic saline (sodium chloride 3%) in your hospital. The challenge we're facing is the fact that it only comes in 500 mL bags, which is look-alike packaging with other IV fluids.
The issue we see is that providing the entire 500 mL bag for a bolus (often 100 mL or 250 mL) means dispensing a high-alert medication in a volume that doesn’t match the intended dose. This presents a risk for unintentional re-initiation of the remaining volume, especially since hypertonic saline is a high-alert medication.
We are considering alternative processes, such as transferring the exact amount needed (e.g., 100 mL or 250 mL) into an evacuated bag for dispensing. However, I would love to hear how others have approached this situation.

  • Do you use pre-measured volumes in your processes?
  • What safety measures have you put in place to mitigate the risks of look-alike packaging and incorrect administration?

I'm especially interested in hearing about any considerations or safety measures that proved crucial as you scoped your processes.
Thanks in advance for sharing your experiences and suggestions.