👤 By the CinnaEMS Content Team🕐 Updated 2026-09-27🏷️ Trauma🔖 Free to read, print, and share
Also known as: permissive hypotension · fluid resuscitation · hemorrhagic shock · lethal triad · trauma triad of death · damage control resuscitation · septic shock
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Use this quick-reference guide to recognise, treat and hand over Shock Resuscitation & Fluid Strategy on the NREMT and on the call. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
📌 Bleeding
Stop it first
Small boluses to a radial pulse
Keep warm
📌 Head Injury
No permissive hypotension
Avoid any low BP
📌 Sepsis
Early bolus · reassess
Still low → vasopressor
📌 Cardiogenic
Little or no fluid
Lungs before and after
📚 Shock Resuscitation & Fluid Strategy — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what changes the plan, and what to hand over.
Fluids treat some shock and worsen others. In hemorrhage the answer is bleeding control and blood, not large volumes of crystalloid; in sepsis early fluid matters; in cardiogenic shock fluid can drown the lungs. The exam rewards matching the fluid plan to the cause.
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Key points
Understand these first
Hemorrhagic shock: stop the bleeding first, then small boluses to a palpable radial pulse or mentation.
Permissive hypotension does NOT apply to traumatic brain injury — avoid any hypotension there.
What are the priority actions for Shock Resuscitation & Fluid Strategy in the field?
Control external hemorrhage before starting IV access. Reassess mental status, pulse and lung sounds after every bolus. Rapid transport to definitive care — surgery and blood fix hemorrhage.
What findings in Shock Resuscitation & Fluid Strategy change your plan or your transport decision?
Crackles after a fluid bolus. Narrowing pulse pressure with rising heart rate. Cold, shivering trauma patient.
What do I need to know about Shock Resuscitation & Fluid Strategy for the NREMT?
Hemorrhagic shock: stop the bleeding first, then small boluses to a palpable radial pulse or mentation. Permissive hypotension does NOT apply to traumatic brain injury — avoid any hypotension there. Lethal triad: hypothermia, acidosis and coagulopathy — keep trauma patients warm. Septic shock: early fluid bolus with reassessment, then vasopressors if pressure stays low.
What should the crew communicate or document for Shock Resuscitation & Fluid Strategy?
Large crystalloid volumes dilute clotting factors and cool the patient.
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Quick Tip
Hemorrhagic shock: stop the bleeding first, then small boluses to a palpable radial pulse or mentation.