Hypothetical algorithm for therapeutic hypothermia in the pre-hospital and early hospital care of traumatic hemorrhagic shock. Question marks mean that studies are required to determine the best method. (A) Current strategy suggested by professor Samuel A Tisherman and colleagues from Safar Center for Resuscitation Research in the USA. (B) SSFR may be needed during the whole process of mild hypothermia, or perhaps it may be needed only in the initial period of mild hypothermia (not shown). AFR, aggressive fluid resuscitation; ED, emergency department; LFR, limited fluid resuscitation; MAP, mean arterial pressure; SSFR, step-by-step fluid resuscitation; Ta, target body temperature.