July 29, 2013

Guideline Title

Guidelines for prehospital fluid resuscitation in the injured patient.

Bibliographic Source(s)

Cotton BA, Jerome R, Collier BR, Khetarpal S, Holevar M, Tucker B, Kurek S, Mowery NT, Shah K, Bromberg W, Gunter OL, Riordan WP Jr, EAST Practice Parameter Workgroup for Prehospital Fluid Resuscitation. Guidelines for prehospital fluid resuscitation in the injured patient. J Trauma. 2009 Aug;67(2):389-402. [73 references] PubMed External Web Site Policy

Guideline Status

This is the current release of the guideline.

Guidelines for prehospital fluid resuscitation in t... [J Trauma. 2009] - PubMed - NCBI

2009 Aug;67(2):389-402. doi: 10.1097/TA.0b013e3181a8b26f.

Guidelines for prehospital fluid resuscitation in the injured patient.

Cotton BA, Jerome R, Collier BR, Khetarpal S, Holevar M, Tucker B, Kurek S, Mowery NT, Shah K, Bromberg W, Gunter OL, Riordan WP Jr; Eastern Association for the Surgery of Trauma Practice Parameter Workgroup for Prehospital Fluid Resuscitation.

Source

Department of Surgery, University of Texas Health Science Center, Houston, Texas 77030, USA. bryan.a.cotton@uth.tmc.edu

Abstract

Although the need and benefit of prehospital interventions has been controversial for quite some time, an increasing amount of evidence has stirred both sides into more frequent debate. Proponents of the traditional "scoop-and-run" technique argue that this approach allows a more timely transfer to definitive care facilities and limits unnecessary (and potentially harmful) procedures. However, advocates of the "stay-and-play" method point to improvement in survival to reach the hospital and better neurologic outcomes after brain injury. Given the lack of consensus, the Eastern Association for the Surgery of Trauma convened a Practice Management Guideline committee to answer the following questions regarding prehospital resuscitation: (1) should injured patients have vascular access attempted in the prehospital setting? (2) if so, what location is preferred for access? (3) if access is achieved, should intravenous fluids be administered? (4) if fluids are to be administered, which solution is preferred? and (5) if fluids are to be administered, what volume and rate should be infused?