Upon arrival at the trauma center, which of the following patients is least likely to receive aggressive fluid resuscitation as an early intervention?
1. The patient with an open abdominal wound from a car accident
2. The patient whose hands were burned in a kitchen fire
3. The patient with a serious head injury from a fall
4. The patient whose leg was severed in an industrial accident
The patient with an open abdominal wound from a car accident
Rationale: For a patient who is actively bleeding, increasing the arterial blood pressure through administration of fluids can dislodge clots and interfere with the hemostatic mechanisms that manage clotting. Current data suggest that aggressive fluid resuscitation may be useful for patients with head injuries, thermal injuries, and isolated injury to an extremity.
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