EMERGENCY FLOW CHART

Is this person experiencing nausea,

weakness/fatigue, confusion, headaches,
and/or blurred vision?

NO

YES
If so, does this person show signs of
frequent urination, increased thirst,
vomiting, and/or shortness of breath?

NO

Is this person showing other symptoms

such as nervousness, shakiness,
sweating, rapid heartbeat, and/or dizziness?

YES

This person is most

likely diagnosed with
hyperglycemia meaning high blood glucose
(blood sugar).

NO

YES

This person is most

likely diagnosed with
hypoglycemia meaning low blood glucose
(blood sugar).

First, please remain calm before administering IV fluid. Next, use the
hypotonic fluid, 0.45% NaCl, because it will help assist in maintaining
the daily body fluid requirements. This solution will provide water, sodium, and chloride; it will replace natural fluid losses and offer a low
level of caloric intake. This fluid will help treat the patient since the
fluid is shifted into the cell, however, be cautious of how the fluid shift
will affect other body systems. Hypotonic solution has a low concentration, and infusing this solution into the circulatory system will cause
an unequal solute concentration. Furthermore, the infusion will lower
the serum osmolality causing the fluid to shift and hydrate the cells.
DO NOT use the hypotonic solution for patients will liver disease,
trauma, or burns; monitor the patient for signs of fluid volume deficit.

Hypertonic sodium chloride solutions contain a higher concentration of sodium and

chloride than that normally contained in plasma. Examples include 3% sodium chloride (3% NaCl), with 513 mEq/L of sodium and chloride, and 5% sodium chloride
(5% NaCl), with 855 mEq/L of sodium and chloride. As the infusion of these hypertonic solutions raise the sodium level in the bloodstream,osmosis comes into play,
removing fluid from the intracellular space, and shifting it into the intravascular and
interstitial spaces. When using hypertonic solutions maintain vigilance when administering because of their potential for causing intravascular fluid volume overload and
pulmonary edema. Hypertonic sodium chloride solutions should be administered only
in high acuity areas with constant nursing surveillance for potential complications.
Hypertonic sodium chloride should not be given for an indefinite period of time. Prescriptions for their use should state the specific hypertonic fluid to be infused, the
total volume to be infused and infusion rate,store hypertonic sodium chloride solutions apart from regular floor stock I.V. fluids. Instruct patients to notify a nurse if they
develop breathing difficulties or if they feel their heart is beating very fast. Hypertonic
solutions should not be given to patients with cardiac or renal conditions who are
dehydrated.

Has this person experienced severe burns or lost a large amount

of blood?

YES
When examining their hand, is it
cold? Or, when applying a pressure
their palm, does it take a couple seconds for the blood to rush back in?

YES
First, administer a 0.9% saline
solution if possible. Then, contact.

When the body is delivering nutrients to cells, osmotic pressure is pushing water outside of the cells into the capillaries.
This is because there is a concentration gradient between the
cell and the blood. However, blood pressure is meant to counter this. The blood pressure must be greater than the osmotic
pressure to move blood into the cells and provide them nutrients. Blood pressure depends on the volume of blood in the
persons system, and the diameter of their arteries. Administering a 0.9% saline solution, which is isotonic, would increase
extracellular fluid volume. This extracellular fluid volume increases blood pressure, which prevents the patient from going
into shock.