Consider using balanced fluids in your ED unless you are treating a patient at risk for cerebral edema, or a patient with a chloride responsive metabolic alkalosis, e.g. from gastric losses. Although the superiority of balanced fluids to NS is still debated, balanced solutions have many physiologic advantages. The commonly used balanced fluids, LR and Plasma-Lyte, do not contain supraphysiologic chloride and are buffered by precursors to bicarbonate.

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