Prehospital intravenous fluid replacement in trauma: an outmoded concept?

Details of 235 consecutive trauma patients brought to the Washington Hospital Trauma Center with intravenous infusions in situ were entered into the study. The volume of intravenous fluid administered prior to arrival at hospital and the time over which it was given (the infusion time) was recorded. The initial systolic blood pressure (SBP) on scene and the SBP on arrival at hospital were documented. A mean volume of 383 ml of intravenous fluid was administered over a mean time of 17 min. Of non-trapped patients 98% had infusion times of less than 30 min. Trapped or hypotensive patients were not given significantly more fluid than those who were not trapped or had SBPs of over 100 mm Hg. Because of the uncertain benefits and potential complications of this procedure, intravenous cannulation and fluid replacement may not be appropriate where expected prehospital time is likely to be less than 30 min.