Fluid Resuscitation

INSTRUCTOR PREPARATIONS

• _National EMS Education Standards

LESSON OBJECTIVES

• _Explain the concept of permissive hypotension

• _Discuss research regarding fluid resuscitation

• _Describe Mean Arterial Pressure (MAP) as a tool to better evaluate perfusion

LESSON CONTENT

I. Fluid Therapy

a. Permissive hypotension - allowing specific patients to experience some degree of hypotension in certain settings.

i. The goal of fluid resuscitation is to maintain vital organ perfusion

ii. Level of consciousness is an indicator of vital organ perfusion

iii. Assessment of the level of consciousness may guide the need for fluid administration

iv. Normalization of blood pressure through fluid administration may be harmful and is discouraged

II. Dangers of excessive crystalloid administration

a. Dilution of clotting factors and platelets

b. Physical disruption of a clot

c. Expanding the area of vascular defect as blood pressure increases

d. Enhances red blood cell loss, thus reducing the total oxygen carrying capacity of the blood

e. Research

III. Understand Mean Arterial Pressure (MAP) as a tool to better evaluate perfusion

a. Mean Arterial Pressure (MAP) is a better assessment tool to determine perfusion to vital organs compared to systolic blood pressure.

b. Calculated using the following formula:

i. MAP=Diastolic Pressure +1/3 Pulse Pressure

c. Example: If your patient has a BP of 120/80 then to calculate their MAP:

MAP=80+[(120-80)/3]

MAP=80+40/3

MAP=80+13.3

MAP=93.3 or about 93

d. Aim for a MAP of 60-65mmHG during fluid therapy

IV. Discuss and understand local fluid resuscitation protocol

Instructor Documents to Reference:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3984883/

 

Content Creator: Madison Browning

CAPCE Course Number: 18-EMTP-F3-2208

Total CE Hours: 1

Level: Advanced

EMT-CE uses the NEMSES guidelines as the foundation for every course outline.