Please see the Administrative Bulletin No. 25 - BUL - 15 regarding inventory and use of Lactated Ringer’s:
With the addition of Lactated Ringers (LR) as an approved intravenous (IV) fluid, the following provisions are to be considered:
- Protocol Substitution:
Lactated Ringers may be used interchangeably with Normal Saline (NS) in any protocol where Normal Saline is currently referenced.
- Stocking Requirements:
1000 mL bags of Lactated Ringers may be stocked in place of 1000 mL Normal Saline bags, in accordance with ALS required equipment policies (Policies 407.00 and 409.00).
- Medication Compatibility:
Lactated Ringers is not compatible with IV infusions of Ketamine or Amiodarone (150 mg over 10 minutes). These medications must be mixed with Normal Saline to avoid precipitation during infusion.
- Amiodarone IV Push Administration:
Amiodarone administered as an IV push (e.g., 300 mg initial dose and 150 mg repeat dose during cardiac arrest) may be given with Lactated Ringers as the carrier fluid.
If you have any questions or concerns, please contact the EMS Agency – thank you!