Study of the Knowledge about Crystalloid Solutions in Medical Personnel: A case report

Park, Se Hun; Kim, Kyung Han

Abstract

BACKGROUND
The clinicians frequently use crystalloid solutions to manage inpatients and outpatients. Recently Normosol becomes available but there is little understanding of Normosol. So we surveyed residents to assess the level of knowledge about three crystalloid solutions.
METHODS
The respondents were 46 residents of internal medicine, general surgery, pediatrics, and anesthesiology. The questionnaire asked for the following information: To list the constituents and their concentrations in each 1 litre of normal saline, Hartmann's solution, and Normosol; to match correct pH and osmolality to each solutions; to describe the metabolism and role of lactate in Hartmann's solution.
RESULTS
All 46 (100%) knew that both sodium and chloride ions were present in normal saline. Twenty six (57%) of them knew correct concentration of sodium and chloride. The presence of sodium ion in Hartmann's solution was known by 44 (96%) and its concentration was recognized by 20 (43%). Chloride ion and potassium ion in Hartmann's solution were recognized by 43 (93%) and 42 (91%), respectively. Fifteen (33%) knew correct constituents of Hartmann's solution. Only three (7%) knew correct constituents and their concentration of Hartmann's solution. Thirty six (76%) knew that bicarbonate is formed by metabolism of lactate. No one accurately recorded the correct constituents of Normosol.
CONCLUSIONS
The constituents and their concentrations of normal saline are well known to residents but those of Hartmann's solution and Normosol are not. Our survey reveals that there was little understanding of the reasons for including lactate in Hartmann's solution and even less of presence of acetate in Normosol.