Page 319 - ATP-P 11th Ed

Hespan (Hetastarch in NaCl) Plasma Volume Expander (Artificial Colloid)
®
Hextend (Hetastarch in Lactated Electrolyte Solution)
®
Description: Plasma volume expander (artificial colloid)
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• Both Hespan and the newer product Hextend are artificial colloids and are used to ex-
pand the plasma volume. The major advantage over crystalloids is that these products give
more volume expansion for a longer period of time for the same infused volume. These
products are not blood or plasma replacements, they have no oxygen carrying capacity, and
they have no coagulation properties. These products should not be the primary fluid
used to treat dehydrated patients, but can be used if no other fluids are available.
Indications: Treatment of shock secondary to hemorrhage
Dose:
• Patient in shock, bleeding not controlled: hold fluid and control bleeding.
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• Patient in shock, bleeding controlled: start 500mL of Hespan /Hextend IV, check for
improvement in BP.
° Titrate to SBP of 85 OR improvement in mental status AND presence of radial pulse.
Hold further fluid when either improvement point is met.
• Patient still in shock after first 500mL of Hespan /Hextend ; start second 500mL bag SECTION 3
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and titrate to improvement.
K9 Dose: 500mL IV over 20–30min
Contraindications:
• Known bleeding disorders or uncontrolled hemorrhage
• CHF
• Renal impairment
• Not for use in children under 12 years
• Use with caution in pregnancy
Pregnancy Category C
Side-effects:
• Nausea/vomiting
• Peripheral and facial edema
• Urticaria
• Flushing chills
Adverse reactions: Severe anaphylaxis (rare)
TMEP use:
• TCCC/TTP
• K9 Trauma Management Protocol
Ibuprofen (Motrin )
®
Description: NSAID, analgesic, antipyretic. Cox-1 inhibitor.

ATP-P Handbook 11th Edition 309