Question: On medical VSA's, as an IV certified PCP, if you have time and enough hands to start an IV, are you giving a fluid bolus? I realize when you get a ROSC you are doing a fluid bolus of 10ml/kg (if chest is clear), but while the patient is VSA, are you giving a bolus? Or are you starting a line, just running TKVO in preparation of getting a ROSC and then bolusing?
Great question. We would suggest that in the scenario described, a fluid bolus is not indicated. Please note that such fluid boluses are not included as part of the Medical Cardiac Arrest Medical Directive for PCP.
This directive can be found on our website (on page 18) here:
While in some cardiac arrest subtypes such as PEA a fluid bolus is indicated (ACP only), for many/most cardiac arrests there is little if any benefit to IV fluid boluses as a routine.