In my mind nothing is as synonymous with hospitals as a bag of intravenous saline hanging from
a little metal tree.
They’re practically ubiquitous in emergency rooms and it’s a serious problem when they’re
in short supply.
Normal Saline, as it’s called, is incredibly simple, it’s mostly just sterile water and
about point-nine percent good old fashioned sodium chloride, aka table salt.
When injected intravenously it’s used to help deliver drugs or rehydrate patients.
Doctors prescribe it to treat a variety of symptoms.
Headache?
Saline.
Vomiting?
Saline.
Lightheaded?
Saline.
It’s like Salt Bae became a doctor, just sprinkling a little salt into everyone’s
veins.
But for something so vital to modern medicine, it’s surprisingly under studied, and there
may be something better out there.
The practice of saline injection is rooted in the 1830s, when cholera was booming worldwide
and everyone was pooping themselves to death.
Scottish doctor Thomas Latta started treating the severe dehydration caused by fluid loss
in the most direct way possible, by pumping fluid right back into the bloodstream.
Physicians back then didn’t know too much about what was in blood but they knew it tasted
salty.
Which is a weird thing to know, but moving on.
So, Latta’s first intravenous solution had a mix of salt and sodium bicarbonate, better
known as baking soda.
Apparently doctors back then just rummaged through their kitchen for medicine.
It’s ok though, Dr. Latta said the first person he tried it on was practically
dead anyway so NBD.
The point-nine percent saline solution we use today stems from an 1883 experiment by
Dutch scientist Dr. Hamburger.
I love that name.
Dr. Hamburger concluded that was the concentration of sodium and chloride in human blood and
so an intravenous solution should have the same levels to be normal.
Hence the name, “normal saline.”
Somehow, and no one’s quite sure how, Dr. Hamburger’s results became the basis for
IV fluids that we still use to this day.
But Dr. Hamburger was wrong.
His estimates were a little too high for sodium, and much too high for chloride.
Still it wasn’t until the 80s that scientists started studying possible downsides, and found
that normal saline caused kidney damage in dogs and later that it could turn blood acidic.
But there may be a better solution.
See what I did there?
Because solution can mean- forget it.
A contemporary of Dr. Hamburger, Sidney Ringer, concocted a fluid with levels of sodium, chloride,
and potassium that are similar to blood’s.
It’s called lactated Ringer’s solution, and only in 2018, 135 years after Dr. Hamburger’s
incorrect conclusion, were the two IV fluids compared in a randomized trial.
Researchers tested the two fluids on over 15,000 ICU patients, and the results aren’t
mind-blowing at first glance.
Patients who received a balanced solution like lactated Ringer’s fared a tiny bit
better, with one percent fewer either dying or suffering kidney problems.
One percent, big whoop right?
Until you remember just how ubiquitous normal saline is, how many millions of adults receive
it each year.
Considering lactated Ringer’s costs about the same as normal saline, it looks like there’s
no reason not to prescribe it instead, and this is a helpful reminder to reexamine what
we accept without second thought just because it’s the way we’ve done things in the
past.
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Put a little bit of salt water in your veins and you’re fine, but put the wrong type
of blood in and you’re in trouble.
Why our our bodies compatible with some blood types but not others?
Check out this video of a little baby me to learn more.
One last thing, maybe you’ve figured this out already, but you can actually make your
own saline at home!
But, y’know, don’t.
Thanks for watching, don’t get too salty because there’s always more videos here
on Seeker.