1-7. Shock / Hypovolemia

For systolic BP < 90 mmHg which is considered to be secondary to hypovolemia:

1) Administer supplemental oxygen as needed

2) Establish IV access with Normal Saline “NS” and infuse at a rapid rate.

3) If unable to start IV within 2 minutes, you may choose to obtain vascular access by IO

4) Do not delay transport

5) Establish second vascular access with NS while en-route: Infuse NS at a rapid rate until:

BP is ≥ 90 mmHg systolic (110 if a severe head injury is also present) - then reduce to a TKO rate and monitor VS

6) If BP does not improve:

check for signs of a cardiogenic cause on the ECG monitor

or signs of obstructive shock such as neck vein distention and if these signs are present, reduce IV/IO infusion rate to TKO