RCC Thompson. "Physiological" 0. 9% Saline in the Field Resuscitation opf Trauma

The debate over which fluid is most suitable for resuscitation of hypovolaemia has been going on for more than five decades. The choice of colloid or crystalloid varies; largely depending on personal preference, clinical experience, availability, and cost (1). Although the evidence for, and understanding of, different fluids has increased, there is an urgent need for appropriately sized, prospective, randomised, controlled trials in fluid resuscitation (1,2). ‘Physiological’ 0.9% saline has been available for over one hundred years (3). Its use has been accepted by long practice and it is often used as a standard by which to compare other intravenous fluids. However, the scientific evidence base for the use of intravenous 0.9% saline is limited. This article will examine the actions and interactions of 0.9% saline in the context of trauma resuscitation and compare its advantages and disadvantages with other fluids which are commonly used.