1. Shock Fluid Guidelines

2. OLD protocol “IV NS bolus 20cc/kg”

3. NEW protocol “IV bolus 200-500mL” “In general, 2 liters is considered a maximum total dose.”

4. Excess saline administration contributes to: Hypothermia Coagulopathy Hemorrhage

5. 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.”

6. Signs of improvement Decreased tachycardia Improved LOC Improved skin signs Once you achieve these, reduce saline flow

7. Mainstays of care Oxygen Warmth Rapid transport