Goal

Determine when to stop administration of blood products. It may be difficult to determine when to stop resuscitation and transition to maintenance monitoring and care. Patients may have abnormal vital signs for many reasons. Obtain teleconsultation if targets are not being met and/or trending in the wrong direction.

Slowing heart rate, palpable peripheral pulses, brisk capillary refill, warming extremities, improving mental status (if no brain injury), slowing/cessation of coagulopathic bleeding (wounds and/or IV site bleeding).

Note: Improving trends are as important as meeting absolute goals when assessing response.

 

 If laboratory values do not improve or trend in the wrong direction for two or more different values, either additional resuscitation and/or hemorrhage control interventions are needed or the injury is not survivable given resources and capabilities available. Consider teleconsultation. Expectant management may be appropriate in some circumstances.