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Fluid Resuscitation: A Defence Medical Services Delphi Study into Current Practice
  1. Major C Wright, RAMC, Specialist Registrar in Emergency Medicine1,
  2. P Mahoney, DMACC RCDM, Defence Professor of Anaesthesia and Critical Care2,
  3. T Hodgetts, ADMEM RCDM, Defence Professor of Emergency Medicine3 and
  4. R Russell, ADMEM RCDM, Senior Lecturer in Military Emergency Medicine4
  1. 1Selly Oak Hospital, Birmingham
  2. 2DMACC RCDM
  3. 3ADMEM RCDM
  4. 4Institute of Research and Development, University of Birmingham Research Park, Vincent Drive, Edgbaston, Birmingham
  1. Selly Oak Hospital, Birmingham, B29 6JD0121 415 8848 0121 415 8869 wright{at}armymail.mod.uk

Abstract

A Delphi study was carried out to investigate recent changes in the fluid resuscitation of patients. A thirty member panel was selected primarily from the UK Defence Medical Services but also included contributors from other NATO members and civilian practice. The study was carried out in two rounds and achieved consensus on a range of statements relating to fluid resuscitation. Key recommendations are grouped by category. Statements reaching consensus included the use of adult intraosseous access, limited hypotensive resuscitation and goal directed therapy in trauma patients. Consensus was not achieved with respect to the selection of non-oxygen carrying synthetic colloids. The study provides a broad review of current practice and adds to previous consensus publications on fluid resuscitation.

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