Fluid Resuscitation
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: 21-EMTP-F3-2208
Total CE Hours: 1
Level: Advanced
EMT-CE uses the NEMSES guidelines as the foundation for every course outline.
