abstract
Urban Emergency Medical Services benefit from an increased number of higher-level personnel (Advanced Emergency Medical Technicians and Paramedics) responding to all calls that are trained to obtain intravenous access. Current Advanced Trauma Life Support guidelines require all trauma patients to receive intravenous access, and as such it is essential for EMS clinicians to be conversant with situations which may require fluid resuscitation. These situations are especially common in rural or austere environments as long transport times require EMS clinicians to maintain adequate hemodynamics until arrival at a trauma center for definitive care. Historically, crystalloid solutions have been the mainstay of fluid resuscitation with Normal Saline or Lactated Ringer’s solution being preferred. Despite the recent shift in best practices from aggressive fluid resuscitation to delayed or significantly scaled back fluid resuscitation in most settings of trauma, it is essential for EMS clinicians to understand when fluid resuscitation is indicated, or, more importantly, contraindicated. EMS clinicians must be comfortable with the various fluids available to them in the field. This review provides an overview of the most common crystalloid fluids and blood component therapies which may be used for resuscitation in the prehospital setting.
