How 10mL of fluid and a blanket can save your life (and a few interesting facts about clotting mechanisms)
First of all, the 10mL of fluid is not saline. In fact, two decades of research tells us that aggressive crystalloid resuscitation is harmful.[1]
Saline presents many challenges when used to resuscitate hypotensive patients:
- It’s acidic nature causes the body to use and deplete its natural buffers which leads to increased acidosis
- It is pro-inflammatory and is associated with poor outcomes
- It dilutes clotting factors
- It is often cold and contributes to hypothermia
All of this increases mortality by exposing the patient all three aspects of the Trauma Triad of Death:
- Hypothermia
- Coagulopathy
- Metabolic Acidosis