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Which vascular access technique should be chosen during hypovolemic shock?

  • Anna Drozd
    Correspondence
    Corresponding author. Department of Emergency Medicine Medical University of Warsaw, 4 Lindleya Str, 02-005 Warsaw Poland. Tel.: +48 784396632
    Affiliations
    Emergency Medicine Student Research Circle at the Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland
    International Institute of Rescue Research and Education, Warsaw, Poland
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  • Marcin Madziała
    Affiliations
    Department of Emergency Medicine, Medical University of Warsaw, Poland
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      One of the immediate life-threatening conditions in emergency medical services practice is shock [
      • Smereka J
      • Madziała M
      • Szarpak L
      Are firefighters able to perform intraosseous access and start fluid resuscitation in an anaphylactic patient?.
      ]. Hypovolemic shock belongs to the most often encountered types and is mainly related with trauma. Fluid resuscitation and thus maintaining adequate blood pressure are of critical importance for the patient's survival. Fluid resuscitation is a priority, especially in the case of hemorrhagic shock without ongoing bleeding. In the prehospital setting, emergency procedures should include obtaining intravascular access and fluid resuscitation with 0.9% NaCl or Ringer lactate (1000 mL) to maintain the systolic pressure at the level of 90 mm Hg (110 mm Hg optionally in head trauma) [
      • Szarpak Ł
      • Madziała M
      Epidemiology of cranio-cerebral injuries in emergency medical services practice.
      ,
      • Szarpak L
      • Truszewski Z
      • Smereka J
      • Krajewski P
      • Fudalej M
      • Adamczyk P
      • et al.
      A randomized cadaver study comparing first-attempt success between tibial and humeral intraosseous insertions using NIO device by paramedics: a preliminary investigation.
      ].
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