Shock Fluid Guidelines

OLD protocol

“IV NS bolus 20cc/kg”

NEW protocol

“IV bolus 200-500mL”

“In general, 2 liters is considered a maximum total dose.”

Excess saline administration contributes to:

• Hypothermia

• Coagulopathy

• Hemorrhage

The goal

• Increased perfusion

• Improved mentation

• Generally a systolic BP of 80-90 should achieve these goals

• If not, the answer isn’t “more saline.”

Signs of improvement

• Decreased tachycardia

• Improved LOC

• Improved skin signs

• Once you achieve these, reduce saline flow

Mainstays of care

• Oxygen

• Warmth

• Rapid transport