BCEN CFRN Practice Question

According to the most recent Advanced Trauma Life Support (ATLS) guidelines, the initial management for hemorrhagic shock may begin with a judicious bolus of a warmed isotonic crystalloid solution, such as Lactated Ringer's or normal saline. This is considered a temporizing measure. The modern standard of care, known as Damage Control Resuscitation (DCR), emphasizes minimizing crystalloid administration to avoid dilutional coagulopathy, hypothermia, and acidosis. The primary goal is to transition rapidly to hemostatic resuscitation with blood products (packed red blood cells, plasma, and platelets) in a balanced ratio. While packed red blood cells are essential, they are part of the subsequent balanced resuscitation strategy, not typically the very first fluid administered in isolation. Hypertonic saline may be considered for patients with concurrent traumatic brain injury but is not the primary choice for hemorrhage alone. Colloids like albumin are not a first-line choice in initial trauma resuscitation.