Special Operations Forces Medical Handbook

7-15

FluidCrystalloids Saline Ringer’s LactateHypertonic Saline 3% 7.5%Hypertonic Saline-Colloid Combinations HTS Dextran HTS HetastarchColloids Albumin Artificial Colloids Dextran Hetastarch *Other commercial names depending on countryOral Rehydration FluidsBlood: Red CellsArtificial blood Hemoglobin based Fluorocarbon based

Table 7-1: Fluid Resuscitation

COL David Burris, MC, USA & Mark Calkins, MD

IndicationHypovolemia Dehydration Hemorrhage Shock, BurnsHemorrhagic ShockBurns-only one dose initially Hemorrhagic ShockBurns? Third day.DehydrationControlled hemorrhageBurnsHemorrhageHemorrhage

O

2

No No No No Yes Yes

Potential BenetEasy to storeInexpensiveEffectiveLighter weightSmall volume = large effectLonger duration of effect than plain HTS?Longer duration1:1 replacement for bloodFluids of opportunity. Non-sterile. Ingredients: 4 tsp sugar, 1/2-1 tsp salt, 1 liter waterIdealEasy storage

CautionsWeight ratio- requires 3:1 for lost bloodDilution, Edema, CoagulopathyHypernatremiaDo not use for dehydration from vomiting, diarrhea or sweatingDo not repeat without addition of other fluidsSee ColloidsOveruse may lead to “leak” into tissueArtificial: CoagulopathyAllergic reactionAustere option in abdominal wounds and unconscious patients, but use with cautionStorage, type & cross-matchExperimental onlyNot yet available for useFuture option?