You are assessing a patient whom you believe is bleeding internally and is in an early stage of shock. After placing the patient on oxygen and positioning the patient, which of the following solutions should you ask your partner to prepare for you as you attempt to initiate an intravenous line?
a. 0.45% normal saline
b. 0.9% normal saline
c. Dextrose 5% in water (D5W)
d. Crystalloids are contraindicated in the treatment of shock. Only whole blood or blood components are used in these situations
b
Rationale: a. Hypotonic solutions enter the cells rapidly leaving the intravascular space making them not suitable for volume replacement.
b. Correct.
c. Hypotonic solutions enter the cells rapidly leaving the intravascular space making them not suitable for volume replacement.
d. While whole blood is most preferable, in the prehospital realm, they are rarely used and crystalloids provide temporary volume expansion until the patient can be delivered to the hospital.
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