. Isotonic crystalloid or colloid solutions can be used for volume
replacement in hemorrhagic shock (I-B). There is no
place for hypotonic dextrose solutions in the management
of hemorrhagic shock (I-E).
7. Blood component transfusion is indicated when deficiencies
have been documented by clinical assessment or hematological
investigations (II-2B).They should be warmed and infused
through filtered lines with normal saline, free of additives
and drugs (II-3B).
8. Vasoactive agents are rarely indicated in the management of
hemorrhagic shock and should be considered only when volume
replacement is complete, hemorrhage is arrested, and
hypotension continues. They should be administered in a
critical care setting with the assistance of a multidisciplinary
team. (III-B)
9. Appropriate resuscitation requires ongoing evaluation of
response to therapy, including clinical evaluation, and hematological,
biochemical, and metabolic assessments. (III-B)
10. In hemorrhagic shock, prompt recognition and arrest of the
source of hemorrhage, while implementing resuscitative measures,
is recommended. (III-B)
Validation: These guidelines have been reviewed by the Clinical
Practice Obstetrics Committee and approved by Executive
and Council of the Society of Obstetricians and Gynaecologists
of Canada.
Sponsors: The Society of Obstetricians and Gynaecologists of
Canada.
J
. Isotonic crystalloid or colloid solutions can be used for volumereplacement in hemorrhagic shock (I-B). There is noplace for hypotonic dextrose solutions in the managementof hemorrhagic shock (I-E).7. Blood component transfusion is indicated when deficiencieshave been documented by clinical assessment or hematologicalinvestigations (II-2B).They should be warmed and infusedthrough filtered lines with normal saline, free of additivesand drugs (II-3B).8. Vasoactive agents are rarely indicated in the management ofhemorrhagic shock and should be considered only when volumereplacement is complete, hemorrhage is arrested, andhypotension continues. They should be administered in acritical care setting with the assistance of a multidisciplinaryteam. (III-B)9. Appropriate resuscitation requires ongoing evaluation ofresponse to therapy, including clinical evaluation, and hematological,biochemical, and metabolic assessments. (III-B)10. In hemorrhagic shock, prompt recognition and arrest of thesource of hemorrhage, while implementing resuscitative measures,is recommended. (III-B)Validation: These guidelines have been reviewed by the ClinicalPractice Obstetrics Committee and approved by Executiveand Council of the Society of Obstetricians and Gynaecologistsof Canada.Sponsors: The Society of Obstetricians and Gynaecologists ofCanada.J
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