Conclusion
A major challenge in research on hypovolemic resuscitation
is the development of an appropriate strategy via
an algorithm that considers all available physiological
parameters. The Advanced Trauma Life Support algorithm
for rapid administration of intravenous crystalloid and/or
blood in bleeding patients11 provides an established and
effective strategy when combined with an appropriate
monitoring of a patient’s physio logical responses to
changes in
blood
volume.
Clearly,
volumes of
intravenous
crystalloid must be tailored to each patient’s particular
physiological needs.19 Therefore, the emergency department
physician is obligated to adjust treatment strategy by
observing the patient’s response as indicated by vital signs
(systolic blood pressure, heart rate, oxygen saturation).
Life-threatening hemorrhage, however, can also be
managed by maintaining a state of permissive hypotension
(systolic blood pressure