emDocs - August 30, 2021 - By Gabrielle Leonard and Aaron Lacy
Reviewed by: Alex Koyfman; Brit Long
Pearls:
- LR composition is more similar to human plasma than NS.
- LR is preferred to NS in select ED presentations, such as DKA.
- LR will not worsen hyperkalemia and the acidosis from NS may in fact be more detrimental.
- LR does contain sodium lactate but will not contribute to clinically significant worsening lactic acidosis.
- NS is preferred to plasma-lyte in patients with TBI.
- Consider NS when mixed with certain medications such as ceftriaxone or blood transfusions to avoid precipitation when only a single IV access site it available.