What is hypovolemia?​

• A reduction in extracellular fluid in the body (any fluid outside the cells, including blood volume)​
• Some causes include:​
  • Hemorrhage​
    • Medical: i.e., GI Bleed​
    • Trauma: Internal or external​
  • Dehydration​
    • Excessive vomiting/diarrhea or sweating​
    • Diuretic use ​
    • Sepsis

What to know about it:​

• Hypovolemic shock may lead to cardiac arrest due to the reduction in cardiac output and resulting reduction in organ perfusion ​

Pre-Hospital Treatments:​

• IV fluids (if available and authorized)​
• External hemorrhage control – Tourniquets, hemostatic dressings, direct pressure​
• Pelvic binder ​
• (New for ALS PCS 5.4) TXA

Why Leave Early?

In short, other fluid volume repletion and treatment of the cause of the volume loss:​

• IV Fluid ​
• Blood products ​
• Treatment of the cause of volume loss​
• Surgical interventions

When to Leave Early?

• IF the patient has arrested from trauma, follow the Trauma Cardiac Arrest Medical Directive​
• When the cause of arrest is non-traumatic but CLEARLY from the fluid or blood loss, consider transporting after a minimum of 1 analysis:​
  • Example: Copious GI bleeding then the patient arrested​
  • Example: Running an ultramarathon, not hydrating, arrests​
• If there is NOT a crystal-clear cause of acute fluid or blood loss that caused the arrest, continue treatment per the standard treatment of the Medical Cardiac Arrest Medical Directive​

**This will be the vast majority of cases

In Summary

• Hypovolemia can reduce cardiac output, leading to shock and cardiac arrest​
• If it is a traumatic cause, follow the Trauma Cardiac Arrest Medical Directive​
• If it is a non-traumatic cardiac arrest consider leaving after 1 analysis only if it is a CRYSTAL CLEAR loss of volume as the cause of arrest (example: GI Bleed who arrests)​
  • The vast majority of cardiac arrests will not be due to obvious acute volume loss and should be managed via "standard" treatment per the Medical Cardiac Arrest Medical Directive

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