Prehospital Trauma Life Support (PHTLS) Practice Test

Which is the preferred fluid for resuscitation of hemorrhagic shock in the prehospital setting?

1. 5% dextrose in water

2. 7.5% hypertonic saline

3. Hetastarch

4. Lactated Ringer's

The correct answer is: Lactated Ringer's

The preferred fluid for resuscitation of hemorrhagic shock in the prehospital setting is Lactated Ringer's solution. This choice is based on several important factors in the management of patients experiencing hemorrhagic shock. Lactated Ringer's is an isotonic crystalloid solution that closely resembles the composition of plasma, making it effective in restoring intravascular volume while also providing electrolytes that can support physiological functions. Its balanced formulation, which includes sodium, potassium, calcium, and lactate, helps to buffer acidosis, commonly associated with shock states, and facilitates better tissue perfusion. In a prehospital setting, where rapid and effective fluid resuscitation is critical to patient outcomes, Lactated Ringer's allows for safe and efficient volume replacement without the additional complications that may arise from more concentrated solutions or synthetic products. It helps to maintain the body's electrolyte balance and is generally well-tolerated in trauma patients. In contrast, hypertonic saline, while useful in certain situations, may require careful monitoring due to shifts in fluid balance and can lead to complications like hypernatremia. Hetastarch is a starch-based colloid that can lead to potential adverse effects including coagulopathy and renal impairment, making it less favorable in