Table 3

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

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

* 2000 ml of isotonic solution in adults; 20 ml/kg bolus of Ringer's lactate in children.

Table reprinted with permission from the American College of Surgeons [37].

Rossaint et al. Critical Care 2010 14:R52   doi:10.1186/cc8943