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Table 3 American College of Surgeons Advanced Trauma Life Support (ATLS) responses to initial fluid resuscitation*

From: Management of bleeding following major trauma: an updated European guideline

  Rapid response Transient response Minimal or no response
Vital signs Return to normal Transient improvement, recurrence of decreased blood pressure and increased heart rate Remain abnormal
Estimated blood loss Minimal (10%-20%) Moderate and ongoing (20%-40%) Severe (>40%)
Need for more crystalloid Low High High
Need for blood Low Moderate to high Immediate
Blood preparation Type and crossmatch Type-specific Emergency blood release
Need for operative intervention Possibly Likely Highly likely
Early presence of surgeon Yes Yes Yes
  1. * 2000 ml of isotonic solution in adults; 20 ml/kg bolus of Ringer's lactate in children.
  2. Table reprinted with permission from the American College of Surgeons [37].