Download Administration of 3.3% Dextrose 0.3% Sodium Choloride

Position Statement - Administration of 3.3% dextrose 0.3% sodium chloride
Intravenous Solution
Practice
Purpose:
To clarify the Alberta College of Paramedics position on Registered EMTs administering intravenous
solution 3.3% dextrose and 0.3% sodium chloride (2/3 1/3).
Notation:
This position statement applies only to EMT practitioners.
AOCP:
The following are the AOCPs related to this position statement:

I-10 Perform Intravenous Therapy
o I-10-3 identifies the various solutions the EMT practitioner can use in their practice. It
does not identify 2/3 1/3 solution.
o In I-10-3 of the EMT-P profile, 2/3 1/3 solution is specified.
Rationale:
Education
EMT programs teach pharmacokinetics and pharmacodynamics of intravenous solutions. It varies
between institutions if they identify the specifics of a hydrating solution versus a crystalloid solution.
This competency is not currently evaluated at the entry to practice licensure exam.
NOCP

5.5 c Maintain peripheral intravenous access devices and infusions of crystalloid solutions
without additives.
o This competency does not specifically mention hydrating solutions
This position statement is effective November 5, 2013 and will be evaluated at discretion of the Practice Manager
and no less than one year from effective date.
Position Statement - Administration of 3.3% dextrose 0.3% sodium chloride
Intravenous Solution
Practice
Current Research
The 2/3 1/3 intravenous solution is a hypotonic solution designed to be used to treat or prevent
dehydration. It can be used in situations to assess kidney status prior to administration of electrolytes.
The dextrose in this solution is readily metabolized by the body leaving water to be transferred to the
body cells.
The risks associated with administration of this solution can result in hyponatremia leading to death. If
there is a disproportionate gain of electrolyte-free water, the patient may become hyponatremic. The
early signs and symptoms of hyponatremia can be non-specific and may be masked by other unrelated
symptoms or medications.
College Position:
Given the above evidence and lack of education of the pharmacokinetics and pharmacodynamics of this
solution at the EMT level, it is reasonable to state that use of this solution is not in the scope of an EMT
practitioner.
If you have any questions please contact the Paramedic Practice Manager at the Alberta College of
Paramedics at [email protected].
This position statement is effective November 5, 2013 and will be evaluated at discretion of the Practice Manager
and no less than one year from effective date.