Essay examples --

Background Hypovolemic shock in trauma victims is a life-threatening condition. In the prehospital environment, EMS providers treat hypovolemic shock by attempting to control hemorrhage and by providing fluid resuscitation with crystalloid solutions. It has long been debated which crystalloid solution provides the ideal fluid resuscitation for victims of traumatic hypovolemic shock; whether it be solutions with similar concentration to human blood (isotonic solutions), or whether fluids should be of higher crystalloid concentration (hypertonic solutions). This report will review the current data on hypertonic versus near isotonic fluid resuscitation for victims of traumatic hypovolemic shock. The main source for this report is a Cochrane Review by Bunn, Roberts, Tasker, and Daksha, 2004. Issues In Trauma Fluid Resuscitation Early Aggressive Fluid Resuscitation According to the National Association of EMS Physicians, older resuscitation outcomes used to call for aggressive fluid resuscitation, typically, 2L IV wide open. More recent studies have found that excessive fluid administration in the prehospital setting can lead to poorer patient outcomes (National Association of EMS Physicians). A prospective trial conducted by Bickell et al. (1994), comparing delayed and immediate fluid resuscitation in 598 patients with penetrating torso injuries and prehospital systolic blood pressures less than 90 mm HG, found that delay of aggressive fluid resuscitation until surgical interventions were available improved patient outcome. Hypotensive Fluid Resuscitation An alternative to aggressive fluid resuscitation is hypotensive fluid resuscitation. A 2011 study by Morrison et al., looking at the clinical outcomes of the first 90 patie... ...2007). Colloids versus crystalloids for fluid resuscitation in critically ill patients (Cochrane Review). Cochrane Database of Systematic Reviews, Issue 4. [Art. No.: CD000567. DOI: 10.1002/14651858.CD000567.pub3] Shackford S, Sise M, Fridlund P, Rowley W, Peters R, Virgilio R, & Brimm J. (1983). Hypertonic sodium lactate versus lactated ringers solution for intravenous fluid therapy in operations on the abdominal aorta. Surgery, 94 (1), 41-51. Shenkin H, Bezier H, & Bouzarth W. (1976). Restricted fluid intake: rational management of the neurosurgical patient. Journal of Neurosurgery, 45 (4), 432–36. Simma B, Burga R, Falk M, Sacher P, & Fanconi S. (1998) A prospective, randomized, and controlled study of fluid management in children with severe head injury: lactated ringer’s solution versus hypertonic saline. Critical Care Medicine, 26(7), 1265–70. Essay examples -- Background Hypovolemic shock in trauma victims is a life-threatening condition. In the prehospital environment, EMS providers treat hypovolemic shock by attempting to control hemorrhage and by providing fluid resuscitation with crystalloid solutions. It has long been debated which crystalloid solution provides the ideal fluid resuscitation for victims of traumatic hypovolemic shock; whether it be solutions with similar concentration to human blood (isotonic solutions), or whether fluids should be of higher crystalloid concentration (hypertonic solutions). This report will review the current data on hypertonic versus near isotonic fluid resuscitation for victims of traumatic hypovolemic shock. The main source for this report is a Cochrane Review by Bunn, Roberts, Tasker, and Daksha, 2004. Issues In Trauma Fluid Resuscitation Early Aggressive Fluid Resuscitation According to the National Association of EMS Physicians, older resuscitation outcomes used to call for aggressive fluid resuscitation, typically, 2L IV wide open. More recent studies have found that excessive fluid administration in the prehospital setting can lead to poorer patient outcomes (National Association of EMS Physicians). A prospective trial conducted by Bickell et al. (1994), comparing delayed and immediate fluid resuscitation in 598 patients with penetrating torso injuries and prehospital systolic blood pressures less than 90 mm HG, found that delay of aggressive fluid resuscitation until surgical interventions were available improved patient outcome. Hypotensive Fluid Resuscitation An alternative to aggressive fluid resuscitation is hypotensive fluid resuscitation. A 2011 study by Morrison et al., looking at the clinical outcomes of the first 90 patie... ...2007). Colloids versus crystalloids for fluid resuscitation in critically ill patients (Cochrane Review). Cochrane Database of Systematic Reviews, Issue 4. [Art. No.: CD000567. DOI: 10.1002/14651858.CD000567.pub3] Shackford S, Sise M, Fridlund P, Rowley W, Peters R, Virgilio R, & Brimm J. (1983). Hypertonic sodium lactate versus lactated ringers solution for intravenous fluid therapy in operations on the abdominal aorta. Surgery, 94 (1), 41-51. Shenkin H, Bezier H, & Bouzarth W. (1976). Restricted fluid intake: rational management of the neurosurgical patient. Journal of Neurosurgery, 45 (4), 432–36. Simma B, Burga R, Falk M, Sacher P, & Fanconi S. (1998) A prospective, randomized, and controlled study of fluid management in children with severe head injury: lactated ringer’s solution versus hypertonic saline. Critical Care Medicine, 26(7), 1265–70.