Blood vs NS Question

[traumamedic]

When would you give blood to a trauma patient instead of NS or LR? What are the indications? For blood is it just when there's a low RBC count? I know you sometimes mix them, I think in a 1:3 ratio, correct? When would that be done?

Thanks in advance.

[taidan]

250cc of hypertonic may get you 500cc from intracellular volume into the vasculature but how long will this fluid last before it either ends up on the floor or thirdspaced? if a patient is losing so much volume that you cannot maintain any sort of hemostasis with blood component, isotonic crytalloid, and colloid fluid... is a touch of hypertonic fluid going to be the silver bullet and saves the day? On the other hand, the patient is clearly having a bad day so why not try all of the guns in your orificenal.

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I agree the intravascular fluid shift may be fairly temporary but, especially pre hospitaly when Blood products and rapid transfusers aren't always available the extra fluid can usually keep a patient alive untill defintive care, oftentimes from my exp. not possible with vanilla LR or NS

[traumamedic]

Excellent, you answered everything I was asking about. Thanks.

[maturner]

I agree the intravascular fluid shift may be fairly temporary but, especially pre hospitaly when Blood products and rapid transfusers aren't always available the extra fluid can usually keep a patient alive untill defintive care, oftentimes from my exp. not possible with vanilla LR or NS

Agreed, if your patient is having a bad day, you do what it takes.

[KRVRN, BSN, RN]

Ok, clearly showing my lack of ER knowledge here... what is vanilla LR?

[taidan]

Ok, clearly showing my lack of ER knowledge here... what is vanilla LR?

lol I just meant normal Ringers With nothing added