Oxygen carrying capacity should be adequate at this level. Prompt surgery to prevent blood loss, autotransfusion and transfusion from compatible relatives must be considered. The type of intravenous fluid administered to a hypovolaemic patient prior to blood transfusion continues to be controversial, and will often depend on local policy and availability. Colloids remain within the blood vessels for longer and should be administered in volumes equal to the blood loss. However, they are excreted by the body and further infusions should be administered as required.
Blood is the best colloid in severe haemorrhagic shock.
It should always be warmed if large volumes are administered rapidly. The amount of fluid given will depend on the type and the extent of the injuries. Whenever possible the fluid should be warmed to prevent further cooling of the patient. If the improvement is short lived, this indicates continuing haemorrhage that requires control. Surgical intervention may be required and further blood transfusion necessary.