Saline Nasal Spray

Salt solution used in several forms:

• IV infusion 0.9% (normal saline): replacing fluid and salt in dehydration, vomiting, diarrhoea, blood loss, shock; as a carrier/diluent for injected medicines
• Hypertonic IV (3%, 5%): severe low blood sodium (hospital)
• Nasal drops/spray 0.65–0.9%: blocked or dry nose, colds, rhinitis — safe for babies
• Eye drops/ointment 5% (hypertonic): corneal swelling (oedema)
• Nebuliser 3–7%: loosening mucus (bronchiolitis, cystic fibrosis)
• Wound and catheter irrigation

IV infusion: volume and rate are decided by the doctor according to age, weight, fluid loss and blood tests — given only by health professionals.

Nasal drops (babies and children): 1–2 drops in each nostril as needed, especially before feeds and sleep; spray (adults/older children): 1–2 sprays per nostril several times daily.

Hypertonic eye drops 5%: 1–2 drops every 3–4 hours; ointment at bedtime.

Nebulised hypertonic saline: as prescribed, usually after a bronchodilator.

IV: fluid overload, high blood sodium, severe heart failure or pulmonary oedema (unless carefully monitored).

Nasal/eye: allergy to any ingredient (rare).

IV: fluid overload (swelling, breathlessness), high sodium or chloride (acidosis) with large volumes, vein irritation at the site; too-rapid correction of low sodium with hypertonic saline can damage the brain (osmotic demyelination).

Nasal: mild stinging.

Hypertonic eye drops: stinging, burning.

Nebulised hypertonic: cough, wheeze.

• IV use: monitor fluid balance and electrolytes, especially in heart, kidney or liver disease, the elderly and children.
• Hypertonic saline only in hospital with sodium monitoring.
• Use a separate nasal bottle for each person.

Safe when used as indicated.

• IV: lithium (salt changes lithium levels); corticosteroids (more fluid retention)
• Check compatibility before mixing drugs into saline.

IV excess: fluid overload, high sodium — needs medical care.

Store below 30°C. Do not freeze. Infusion: use only if clear and the container is intact; discard unused portion. Nasal/eye drops: discard 4 weeks after opening.