Saline Is Based on Terrible Science, Why Do We Use It Every Day?


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. Are you thirsty for a new website, you should
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online and visit Domain.com. 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.

100 thoughts on “Saline Is Based on Terrible Science, Why Do We Use It Every Day?

  1. This video is really reaching, nobody prescribes saline for vomiting, or headaches, if you start your video with a misrepresentation its going to cheapen everything that comes after.

  2. A saline drip is primarily used as a neutral until further information about the patient is obtained such as diabetes.

  3. go to a hospital waiting room in China and you will see HUNDREDS of people all sat down plugged into this shit.
    it is a massive money maker.
    and as the medical workers go from person to person, inserting the central lines, they don't even change the gloves.

    Except 1….. the only white guy in there… clearly the stupid one, since the consensus is you follow the pack.

  4. dhmo.org makes a better argument.

    This video is a terrible abuse of scientific research by people that should know better. For starters, many dehydrated patients also have deficiencies essential electrolytes (e.g. sodium chloride). With patients that need plenty of fluids, doctors often prescribe a mixture of different fluids in order to restore some level of balance in their blood. Just because your quick Google search didn't reveal any studies published, doesn't mean it hasn't been studied extensively. I've worked with docs that have been studying IV fluids for +40 years. Your more likely to suffer I'll effects from the plastic they're stored in over doctors not understanding how to treat their patients correctly.

  5. Normal Saline mixes better with medications and its more convenient. Seeker should really consult a nurse or doctor before publishing stories about medicine. This is pretty well known in the medical field.

  6. This is what happens when laypeople make medical videos. And science of 1% margin is not statistically significant. And also lactated ringer‘s when given to someone precludes that line from ever giving blood. You have to start a second IV in order to give blood because you can’t give blood through a line that has had lactated ringers in it

  7. Dogs are also terrible model for this- they are desert animals with difficulty managing their water/salt since they don't sweat and their natural internals are focusing on conserving water and therefore salt management has come a poor second. Humans are temperate animals. Terrible science is not the word for it- not robust. Medicine lacks a lot of robustness.

  8. What is weird isn’t that we know that blood taste salty (hey, who doesn’t drink human blood from time to time?) but that the word “diabetes” means (roughly) “sweet urine.” Who figured that one out?

  9. Wait, so Saline is based on good science, but contains the 'wrong' ratios of salts to water? But the current saline solution is medically (extremely) useful in lue of a yet-to-be-tested alternative?

  10. The thing that bugs me is how doctors tell you that dietary salt is bad for you but they will not hesitate to have it injected directly into your bloodstream.

  11. Sorry, this is a really terrible forum to discuss an area of complexity and ongoing medical research and debate. Your coverage is missing quite a lot of key info. I take serious issue in your description that the NS fluid is harming patients. These studies showed lower rates of renal dysfunction associated with LR resuscitation and that does NOT equate to NS causing renal damage in the setting of circulatory collapse. In low resource setting, the price difference between NS and LR are not negligible and these trials are reinforcing data that mortality outcome doesn't differ for non-ICU patients. Only in septic ICU patient do we see a clear signal of clinical benefit.

    You referenced only one of two trials published together, SALT-ED and SMART; pertaining to non-ICU and ICU patients. Weakness of both trials was that they were not blinded, single centers, and provider could order off-protocol fluids (a medical necessity but methodologically an area of criticism). Their key strengths were the size of the study and the protocol they designed. For the SALT-ED non-ICU patient the primary outcome of hospital-free days showed NO statistical difference. There was a decrease in MAKE30 secondary outcome which was driven by short term rise in serum creatinine. Need for dialysis was not known so we cannot conclude on any risk for long term renal dysfunction. For the SMART, excluding traumatic brain injury cases, ICU patient resus with LR showed lower rates of MAKE30 (composite of death, need for dialysis or persistent renal dysfunction at day 30) with NNT of 91. But a lot of this is again driven by acute kidney injury. Septic patient derived the most mortality benefit with LR use. These trials are good hypothesis generating that another large randomized blinded trial with long term renal followup could definitively wrap up unanswered questions.

    Your 4 min video is pruning away archives of studies on the different fluids. There are advantages and disadvantages to the use of different crystalloid in different scenario. A clear disadvantage of LR is its incompatibility with quite a few key medications in common use. Yes NS composition is wacky as hell. As outlined above, studies on the benefit compared to other fluids are complex but NS will continued to be used in many settings. I am unsure what benefit your are bringing to the general public with this video. Since IV fluids is a medically prescribed treatment, I fail to see how the general public would gain from this skewed info. Patient can't demand me to prescribe LR if contraindications exist….

  12. This video is based on terrible science. 1% difference? Is that even statistically significant? I think there's a lot more research that would need to be done before they could claim that RL would be better than saline.

  13. 3:06 no no no….thermodynamic law conclude that free energy is impossible, and people believe in it for 300 years so it shouldn't be wrong

  14. saline isn't based on terrible science. It makes use of the fact that to reach isotonicity, you don't need to have the same elements, just the same concentration. And science both hyper- and hypotonic IV saline solutions can be fatal, that has been the primary concern.

  15. This doesn't sound like "terrible" science. Just imperfect science. You come off as clickbaity with titles like this.

  16. Knowing the taste of blood is not weird. I like my steaks rare to medium rare. So bloody steak is okay with me. Also, bloody nose, lost tooth, a knife wound and a few other things that I have had happen to me that i have bled from. So, not so weird, unless you make it weird because you are a weirdo ginger asshat.

  17. Well, that wasn't very interesting. 4:11 I'll never get back.. to bad they didn't do more medical research on this. They left so much out. 🤔 Maybe I shouldn't learn how to be a doctor on YouTube.
    Bummer.. no I have to figure out if chemistry or stupidity would better careers. Hmm it time to ponder.. without seekers help..

  18. There is a reason NS is still the standard. LR can't be given to liver and kidney patients; however, it is great for traumas, burns, and post-surgical patients that meet the criteria for it.

    But from your point of view, why even use LR when you can have something even more balanced such as Plasmalyte or Hartmann's solution? Cost analysis shows Saline as the cheapest option. With healthcare costs already so outstanding, why not optimize health at the lowest cost?

  19. so cringe. unless you are medically trained don't even bother trying to talk about the use of this kind of practice.

  20. ringer's solution maybe better but saline can be pretty much made on the spot as long as you have the right stuff… like a pack of table salt(the ones you can get from mcdonalds and other places) and a bottle full of sterile water… not that you'd be able to make by yourself when you need it(because when you need it, you wouldn't know you need it.)

  21. this is just basic science blown up to make a video modern medicine (although based on a primitive form of medicine) is fine tuned to the best degree currently know. are there areas of improvement , yes . but that doesnt mean that normal saline almost universally used everywhere is a dangerous substance. on the contrary there are times where NS is used and at times RL is used. one is not better than the other both are equal. This is what happens when science oriented people think they can know better than people who have spent almost a decade studying medicine

  22. Unless you are very old you will not given saline for those three first things. No one should take this video seriously, the probably of any type of kidney problem is too low for it to become an issue. Just like any other medicine with side effects if it happens it will wear off soon enough with good care.

  23. The Netherlands: Get's mentioned.
    Me: EEEYYY NEDERLAND IS WEER RELEVANT!!! LANG LEVE DE KONING, LANG LEVE WILLEMPIE!!! 😀

  24. I really hate this channel, all their videos are biased to one side. They present the videos in such a way that even if their arguments are correct, which the usually are, that it just makes me hate them. They also always show up in my suggested feed and it ruins my day.

  25. If the trials showed an only 1% difference then the reason people aren't using it isn't because a 1% difference of better results doesn't matter. The reason people don't use it is because 1% difference basically means the tests is inconclusive.

  26. Huh why not just create a synthetic blood? It probably won't deliver oxygen but it could still rehydrate ppl?

  27. If you want to know why saline is used, go to the ocean, cut your hand, and leave in the water for about 30 minutes. You'll be surprised at how much the wound will heal up. Salt water does wonders.

  28. nothing about osmosis? And Dr. Hamburger is the only researcher for a century? i'm in a youtube hole of shitty clickbait videos.

  29. Any person in here with even a faint amount of medical inclination would be giggling at this video and how wack it is

  30. It's not weird to know what blood tastes like. If you've ever had a nosebleed or bitten your lip or tongue you know.

  31. These guys are just reading aloud the wikipedia article. English version article. Same page in other languages sheds more light into what saline is actually useful for and why is it used. This video and it's title are bullshit.

  32. UHm… when we are talking about people, saving 1 out of 100 is a big deal if you ask me. It certainly needs more study though, …other countries, climates, diets, ethnicity or gene types…

  33. The problem with this video and it's… misunderstanding of the study, is that a 1% margin is literally deemed as a statistically anomaly… No matter how large the sample size is… You need to have at the very least 5% or more to even deem it to be an actual difference outside of just happenstance…

    So whether the exact measure of sodium and chloride/chlorine in saline solution is not directly balanced to a body's natural state is also comparing it directly to its natural state, which would NEVER be the case for someone getting a saline IV in the first place… They are prescribed a saline IV precisely because they are well outside the range of their normal balance of electrolytes and fluid(s), both of which are supplied by either of the referenced saline-solution-options.

    The body meanwhile does not sit idly by, it takes in the fluids and nutrients to use where they are lacking and expels surplus through the… usual avenues… So as long as the dosage isn't wildly outside of a safe concentration, and they aren't, they are in fact purposely compensating for the wildly deficient state the body is already in, which is the whole reason they are receiving the saline IV as you may recall…

    Seeker may have some interesting videos, but there's already one webMD giving people hypochondria and a morsel of knowledge to base their mountain of misunderstanding on… Please don't compound the matter further by trying to condense a VASTLY larger and more involved medial subject down to a single "take this instead and you'll be better than if you use this similar thing" sort of argument.

  34. So many thing that we need to look at, laws, medical procedures, religion. If we look at it to day with, "today's knowledge" we might have to change alot of things.

  35. Can you PLEASEEEEEEEE stop stop stop making up silly unfunny insert joke into your already tiny little no voise soft sound speaking…. better yet stop the shiity background noises music. Thank from your sub

  36. If i understand correctly dying from saline solution is 1% more likely. If the probability of dying from a saline is like 1 in a million wouldnt that make that 1% so irrelevant?

  37. Title: Saline Is Based on Terrible Science, Why Do We Use It Every Day?
    After watching the video, do I know why we use it everyday?: No

  38. Actually saline has sodium in it so the water can go through osmosis and move into the blood cells.

  39. Overuse one thing, of course it'll turn on you. Yet, if the 0.9% saline is a bit to imbalanced for human blood, I should have heard multiple nurses and doctors yelling and panicking at the hospital during the entirety of my training. Also, saline is saline. The 3% solution however, is more for irrigation.

  40. So you're saying NaCl .9% is bad compared to lactated ringers because of a 1% difference? A 5% difference is barely significant let alone a 1%.

  41. 1% doesnt sound much to you? 1% of 15.000 is 150 patients who either die or suffer kidney damage only from those in this study

  42. Plasma-Lyte is the go to solution in the UK. N.Saline, Hartman’s and RL are rarely used. The information in this video is tenuous at best. The other thing to understand is most ICU patients either have or are at risk of AKI which would skew the results.

    If you took healthy volunteers and did the study on them I’m sure you would find quite different results.

  43. please take some responsibility by acknowledging the many many corrections people have given you in the comments to stop misinforming people

  44. I see a lot of patients at my hospital on lactated ringers and normal saline. Didn't realise they were so close chemically.

  45. Hi. My concern about IV fluids is that they have to be injected ( in India I have no idea about other places). The problem is that children and old people feel it very painful. Can someone tell me about alternate methods?

  46. you should of made a video regarding the National shortage of normal saline and how thats even possible instead of making this not so accurate video.

  47. It's mostly used because the hospital gets paid around 300 dollars for a bag of water that costs them 90 cents. That's why every patient gets an IV whether they need one or not.

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