150 meq of NaCl?

[veggie530]

Hey guys,

I'm an RN and also a type 1 diabetic. Recently at work my pump malfunctioned and I received 40-50 units of humalog in a single bolus. Needless to say it was a pain, and I ended up going to the ER to get some IV dextrose.

The physician gave me 500ml of D10 initially (after 14 apple juices and 28 sugar packets), still not enough. So, he gave me 2 liters of D10 with 150meq of NaCl in each bag. The bag said NaCl 24.5% or something like that.

I didn't get a chance to talk to the doc about it because the ER was a zoo and my nurse had never seen it before either. Anyone else seen this or could tell me the indication?

I didn't tolerate all that fluid well. I wasn't dehydrated and the 2nd liter was infused via pressure bag and I had heart palpitations, HR increased from 80's to 120's, chest tightness and dyspnea. It did make my headache go away (lol).

[KatieMI, BSN, MSN, RN]

One bag of standard 0.9% NaCl contains 9 grams of Na or 155 meqs. Here is how:

Molecular weight of Na 23, Cl 35, NaCl 58

Therefore, 1 mole of NaCl = 58 g, 1 mmole= 58 mg = 1 meq, providing 100% dissociation

9000mg (in 1 l bag of standard saline) \ 58 = 155 meq/liter.

You were given slightly hypertensive solution too quickly (If you remember it, that means your blood pressure was high enough for brain function satisfactory, and therefore 2000 cc, close to 40% of your total blood volume, pushed through pressure bag were probably not necessary). Your symptoms were probably more related to cardiac overload.

[chare]

There are 154 mEq of NaCl in 1 liter 0.9% NaCl (NS). It sounds as if the ED MD wanted you to receive D10 NS as compared to D10W.