Which fluid to give?

Crystalloids are generally accepted, as the initial fluid of choice during trauma patient resuscitation but the pragmatic approach is to give a combination of both crystalloid and colloid. Plasmalyte 148 has advantages over both saline and lactated Ringer’s. Medium-or low-molecular weight hydroxyethyl starch may be the colloid of choice. In the future, haemoglobin-based oxygen carriers are likely to play a prominent role in trauma resuscitation.