Saline vs. Lactated Ringers for Emergency Department IV Fluid Resuscitation
Condition: Fluid Loss; Symptom Complex, Triple; Emergencies
MeSH terms: Behcet Syndrome; Emergencies
Intervention: Lactated Ringer Solution; Normal Saline 0.9% Infusion Solution Bag
Intervention description: 2 liters of intravenous lactated ringers solution will be administered by peripheral IV; 2 liters of intravenous normal saline solution will be administered by peripheral IV
Intervention MeSH terms: Pharmaceutical Solutions
Phase: Phase 4
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Masking description: Fluid being administered to participants will be covered by an opaque bag. The investigator calling the participant for follow-up does not know how the participant was allocated.
Enrollment: 157.0
Sex: All
Minimum age: 18 Years
Healthy volunteers: No
Keywords: Normal saline; Lactated ringers; Emergency department

Summary:

      Administration of intravascular (IV) fluid is the most common emergency department (ED)
      procedure. IV fluids are integral to increasing effective blood volume and ensuring organ
      perfusion in patients with volume depletion and dehydration. There are many options of IV
      fluids providers can use when treating ED patients. Surveys show physicians do not cite an
      evidence-based reason for selecting the crystalloid IV fluid used; the decision was likely to
      be influenced by type and location of practice. A gap exists in the current literature, as
      there is no evidence for the optimal IV fluid choice for the ED patient requiring IV fluid
      before discharge.

      Normal saline (NS) is commonly used as an IV fluid replacement in ED patients. However, NS
      has been associated with increased risk of acidosis and acute kidney injury. This study will
      use a novel approach of a patient-centered outcome in a non-critically ill population to
      ascertain the optimal IV fluid for patient quality of recovery. The results of this study
      will inform provider's IV fluid decisions between NS and LR. More importantly, the results of
      this study will have the power to improve patient's quality of recovery following IV fluid
      administration and subsequent ED discharge.

      ED patients will be recruited, and participants will be randomized to receive one of two IV
      solutions (Lactated ringer's or normal saline). Participants will answer a survey before and
      after the intervention to assess their quality of recovery. The post-survey will be
      administered by phone after ED discharge. Participants will also be contacted by text message
      one week following their ED visit to gather information on their healthcare utilization.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Emergency department patient

          -  Chief complaint of nausea, vomiting or emesis, diarrhea, abdominal pain, dehydration,
             heat stroke or exhaustion

          -  ED provider approves administration of two liters of fluid

          -  ED provider states patient is likely to be discharged

          -  Patient has followed up with PCP in the last two years

          -  Patient has access to phone for next two days following ED discharge

        Exclusion Criteria:

          -  Prisoners

          -  Children

          -  Women known to be pregnant

          -  Jaundice

          -  Current chemotherapy