- As a result of the vasodilation and vascular permeability intravenous access is necessary for Intermediates and Paramedics to perform.
- As mentioned, massive fluid shifts occur rapidly causing up to 35% of the intravascular volume to move into the extravascular space within a few minutes.
- Hypotension must be treated especially after the administration of Epinephrine.
- Adults should receive a 1 - 2 liter fluid challenge of normal saline.
- In the pediatric population we remain with the guideline of 20ml/kg of Normal Saline; however children can tolerate large volumes of fluid as long as they are not in cardiogenic shock. [19-21]
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