According the criminal complaint, on June 21, a 55-year-old female coworker of Dr. Ortiz, identified in court documents as M.K., experienced a medical emergency and died immediately after treating herself for dehydration using an IV bag of saline taken from the surgical center. An autopsy report revealed that she died from a lethal dose of bupivacaine, a nerve blocking agent that is rarely abused but is often used during the administration of anesthesia.
According to the complaint, surgical center personnel concluded that the incidents involving M.K. and J.A. suggested a pattern of intentional adulteration of IV bags used at the surgical center. They identified 10 additional unexpected cardiac emergencies that occurred during otherwise unremarkable surgeries between May and August 2022, which the complaint alleges is an exceptionally high rate of complications over such a short period of time.
Raynaldo Rivera Ortiz Jr., a Texas anesthesiologist, was arrested in Plano, Texas, on criminal charges related to allegedly injecting nerve blocking and bronchodilation drugs into patient IV bags at a local surgical center, resulting in at least one death and multiple cardiac emergencies.
According to court documents, on or around June 21, a 55-year-old female coworker of Ortiz, identified in court documents as M.K., experienced a medical emergency and died immediately after treating herself for dehydration using an IV bag of saline taken from the surgical center. An autopsy report revealed that she died from a lethal dose of bupivacaine, a nerve blocking agent that is rarely abused but is often used during the administration of anesthesia.
CIA Medical is a leading provider of medical and surgical supplies. See our list of normal saline IV bags and prices below. Order online, call us at (312) 275-5850, or get a 2-hour custom quote by filling the form on this page.
A normal saline IV bag is one that contains a saline solution. Saline solution is a mixture of sodium chloride (salt) and water and has been used in the medical world for decades. It's a common base for IV bags and lines and is often used as a transport medium to carry other components, like vitamins and minerals, into the body.
Normal saline solution IV bags are typically made of soft plastic or vinyl. They're attached to long tubes, known as IV lines or venous catheters. The fluid inside the bag travels through the catheter and into the body, as the other end of the catheter is inserted into a vein, usually in the hand or arm, but possibly in other parts of the body.
There are many potential uses of saline IV bags. They're commonly used to replenish lost fluids in the bloodstream, sustain patients who are undergoing surgery, or deliver medications into the body in a direct and fast-acting way.
Normal saline IV bags work as follows: the bag is filled up with a prepared mixture of salt and water, otherwise known as saline solution. The bag is then suspended on a stand and connected to a catheter. The catheter is inserted into the patient's body, usually with the help of a needle in the hand or arm. The saline fluid then flows from the IV bag through the tube and into the bloodstream.
Normal saline IV bags are available in a range of different sizes to suit different situations, as some patients may require more saline and longer treatment than others. The most common sizes are 100ml, 500ml, and 1,000ml or 1L bags.
Most normal saline IV bags are very similar, with only small differences in terms of size, materials used, and design. They can vary in size from 100ml through to 1,000ml, may be made of different kinds of soft plastic or vinyl, and can have multiple connection points along the base.
The main use of a normal saline IV bag is to store saline solution, ready for delivery into the body. These bags are relatively simple pieces of medical equipment, but play a valuable role and are vital for the overall functioning of an IV line. They can be used in many situations, such as for patients who are dehydrated, undergoing surgery, wounded, or have various diseases and need to receive treatment.
Isotonic crystalloids contain about the same concentration of osmotically active particles as extracellular fluids, so fluid doesn't shift between the extracellular and intracellular areas. Lactated Ringer's solution and 0.9% normal saline are the two most common used.
The studies involved 28,000 patients at Vanderbilt University who were given IVs of saline or a balanced fluid. For every 100 people on balanced fluids, there was one fewer death or severe kidney problem.
U.S. hospitals are facing widespread shortages of IV bags in the wake of Hurricane Maria, which damaged and temporarily shut down several Puerto Rico factories owned by a major manufacturer of the bags.
IV bags, used to mix and deliver liquid medications or salt water to patients through an intravenous line, are one of the most highly used items in hospitals. There are workarounds to deal with the lack of the bags, such as injecting medications with a syringe. But experts from Harvard T.H. Chan School of Public Health are concerned that the lack of bags could negatively affect patient care.
Fluid therapy is a critical component of the clinical management of patients. It consists of colloid therapy as well as crystalloid therapy. The most commonly used crystalloid worldwide is normal saline which is used in the management and treatment of dehydration (e.g., hypovolemia, shock), metabolic alkalosis in the presence of fluid loss, and mild sodium depletion. This activity describes the indications, action, and contraindications for normal saline as a valuable agent in the use of fluid and electrolyte resuscitation. This activity also highlights the mechanism of action, adverse event profile, and other key factors (e.g., administration, monitoring, relevant interactions) pertinent for members of the interprofessional team in the management of critically ill patients.
Objectives:Identify the indications for the various concentrations of normal saline. Describe the contraindications to normal saline.Review appropriate monitoring parameters for normal saline.Outline interprofessional team strategies for improving outcomes and decreasing adverse effects of normal saline when it is used in critically ill patients. Access free multiple choice questions on this topic.
Normal saline is a cornerstone of intravenous solutions commonly used in the clinical setting. It is a crystalloid fluid administered via an intravenous solution. Its indications include both adult and pediatric populations as sources of hydration and electrolyte disturbances. It can come in various concentrations; the two specifically addressed are 0.9% and 0.45%.
Normal saline is a crystalloid fluid. By definition, it is an aqueous solution of electrolytes and other hydrophilic molecules. The main indication for the use of crystalloid fluids in humans is due to their isotonic nature when compared to serum plasma. In comparison to other types of fluids (e.g., hypertonic, hypotonic), there is less of an osmotic effect. Normal saline contains electrolytes (sodium and chloride ions) which dissociate in solution.
Additionally, water plays an equally important role. Water is a necessary ingredient of the body and comprises more than two-thirds of total body weight. Similarly, the balance of water is primarily under the control of the lungs and kidneys. The distribution of water depends mainly on the concentration of these electrolytes within various compartments. Within these compartments, sodium plays a significant role in sustaining homeostatic concentrations and the distribution of water. Normal saline functions to expand intravascular volume without disturbing ion concentration or causing large fluid shifts between intracellular, intravascular, and interstitial spaces.
The use of normal saline can contribute to iatrogenic fluid overload. This complication is particularly concerning in patients with impaired kidney function (acute kidney injury, chronic kidney disease, etc.), and these patients should, therefore, receive treatment with judicious use of intravenous fluids.
Patients with congestive heart failure are at an increased risk for detrimental effects of normal saline administration. In these patients, fluid overload is a considerable concern; this can lead to life-threatening pulmonary edema and the worsening of diastolic or systolic heart failure, leading to end-organ damage or even death. It is vital for the clinician to monitor these patients carefully and to administer the minimum required volume to maintain homeostasis.
Adverse effects of normal saline may occur secondary to solution or technique of administration. These effects include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation, and hypervolemia. Additionally, if infusing normal saline in large quantities, chloride ions will be vastly increased within the blood. This influx of hyperchlorhydria causes an intracellular shift of bicarbonate ions to allow for equilibria. Overall, this decreases the number of bicarbonate ions available for buffering. Due to the net acidosis, this physiological change will also cause an increase in serum potassium levels due to the transcellular shift of potassium from within the cell into the extracellular space.
Contraindications for the use of normal saline are evaluated clinically from patient to patient. If the implementation of normal saline results in dilution of serum electrolyte concentrations, overhydration, congested states, or pulmonary edema, then its use is strongly discouraged.
Additionally, the infusion of more than one liter of isotonic (0.9%) sodium chloride per day may supply more sodium and chloride than physiological levels, which can lead to hypernatremia, as well as hyperchloremic metabolic acidosis. Therefore, patients receiving large volumes of normal saline require monitoring for electrolyte imbalances. 781b155fdc