The IV Infusion Pump

🧠 How fluid resuscitation really works

Resuscitation isn't one big bag — it's give a bolus, then reassess. After each isotonic bolus, check: is the blood pressure / MAP coming up (target MAP ≥ 65), is capillary refill ≤ 3 seconds, is the patient more alert, is urine output improving, is the lactate trending down (aim for a drop each recheck)? If yes and they're still responding, give another measured bolus. If the pressure stays low — or you hear new crackles, the oxygen drops, or edema appears — stop the fluid and escalate: persistent low pressure needs a vasopressor (norepinephrine is first-line, titrated to keep MAP ≥ 65), not endless fluid. Guidelines start around 30 mL/kg of balanced crystalloid, then let these reassessment signs guide the rest — both too little and too much fluid cause harm.