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Figure 2.3 Algorithm for fluid management in hypotensive shock Hypotenive shack Fluid resuscitation with 20 ml/kg istonic erystllid or ‘coloid over 15 minute Tyy to cbtain a HCT level before uid Yes Crytatlid/collid 10 ml/kg /be for 1 hour, hen continue wih IMerystolleid 5-7 ml/ha/hr for 1=2 hours, reduce to 3-5 ml/lig/br for 2 hours Het te hich ery reduce to 2-3 ml/kg/be for 2-4 hour. I potent coninses to improve, Fid con be } 1 {ether edd, ‘Ackwiniter 2nd bolus Bid (elloid) Canidar significant oerult/owert bleed Meniter HCT hou 10-20 mi/ig over Ye to | hour Iie rasisen wth rsh whole Ifthe patients net stable, act ozcorcing toHCT lovee: iF HCT increases, consider bolus uid tedminishaton or increas Bud edrinihation et iFHCT decreases, consider ransfsion wih Improvement fresh whale ranshsion — Stop ot 48 hous. ves No Repost 2nd HCT HT for high Her Administer rd bolus fluid (colloid) 10-20 mi/ig over | hour NO Repeat 3rd HET