fluid+replacement

clinical home > primary survey > circulation toc =Fluid replacement =

How much fluid?
Current guidance in the UK is to give IV fluids prehospital for shock only if the severity of the shock is sufficient to cause the radial pulse to be impalpable. If you're not sure whether or not a fluid challenge will help, one option is to give a small bolus and see what effect it has; another is to elevate the casualty's legs. If that improves central circulation they will probably benefit from fluid.

Which route?
Routes of giving fluid:

Avoid if abdominal wound. || Used if IV access not possible. || <200ml/hr. || In patients/casualties who are wet from rain or sweat it can be difficult to secure an IV cannula and giving set; clingilm wrapped around the arm and the giving set is effective in this setting.
 * Oral || Can use any “potable” fluid, need conscious casualty.
 * IV || Need sterile fluids, can give high volumes. ||
 * IO || Need sterile fluids, can give high volumes.
 * Rectal || Use only if no other route or not sterile fluid.

Links
[|Venous access] [|IV fluids] [|Fluid resuscitation] [|Vascular access in children] [|Rectal proctoclysis article]

Videos
video of sternal intraosseous access with FAST device: media type="youtube" key="v_G6I27XTj0?version=3" height="390" width="640"

video of tibial io needle insertion

media type="youtube" key="3pZxOqfB3YA?version=3" height="390" width="480"