Florida State Paramedic Practice Exam

What type of fluid should be avoided when treating a patient with a closed head injury?

1. Sugar solutions

2. Normal saline

3. Lactated Ringer's solution

4. D5W

The correct answer is: Sugar solutions

In the context of treating a patient with a closed head injury, the administration of sugar solutions, such as those containing dextrose, should be avoided. The rationale behind this is that hyperglycemia—or an elevated blood sugar level—can exacerbate cerebral edema and worsen outcomes in patients with head injuries. When sugar solutions are infused, they can lead to increased osmotic load on the brain, which may heighten swelling and intracranial pressure. Maintaining a stable and non-hyperglycemic environment is crucial for promoting recovery and minimizing complications related to brain injuries. Other options, such as normal saline, lactated Ringer's solution, and D5W, can be used under specific circumstances. Normal saline and lactated Ringer's are isotonic solutions that help maintain fluid balance without contributing to potential complications associated with increased glucose levels. Though D5W contains dextrose, its concentration is lower than concentrated sugar solutions and may be used with caution if carefully monitored, but it's typically not the first choice in an acute traumatic scenario. Thus, avoiding sugar solutions altogether helps mitigate the risk of worsening the patient's condition.