Figure 2.3 Algorithm for fluid management in hypotensive shock
Hypotenive shack
Fluid resuscitation with 20 ml/kg istonic erystllid or
‘coloid over 15 minute
Tyy to cbtain a HCT level before uid
Yes
Crytatlid/collid 10 ml/kg /be for
1 hour, hen continue wih
IMerystolleid 5-7 ml/ha/hr for 1=2 hours,
reduce to 3-5 ml/lig/br for 2 hours Het te hich ery
reduce to 2-3 ml/kg/be for 2-4 hour.
I potent coninses to improve, Fid con be } 1
{ether edd, ‘Ackwiniter 2nd bolus Bid (elloid) Canidar significant oerult/owert bleed
Meniter HCT hou 10-20 mi/ig over Ye to | hour Iie rasisen wth rsh whole
Ifthe patients net stable, act ozcorcing
toHCT lovee:
iF HCT increases, consider bolus uid
tedminishaton or increas Bud edrinihation et
iFHCT decreases, consider ransfsion wih Improvement
fresh whale ranshsion —
Stop ot 48 hous.
ves No
Repost 2nd HCT
HT for high Her
Administer rd bolus fluid (colloid)
10-20 mi/ig over | hour
NO
Repeat 3rd HET