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After initial stabilization of airway and breathing, the most important nursing intervention is to ensure timely fluid replacement. Fluid resuscitation is most efficient through a short, large-bore peripheral intravenous (IV) catheter in a large peripheral vein. The IV line should have a short length of tubing from the bag or bottle to the IV site. If pressure is applied to the bag, fluid resuscitation occurs more rapidly. If fluids can be warmed before infusion, the patient has a lower risk of hypothermia.

Positioning the patient can also increase perfusion throughout the body; place the patient in a modified Trendelenburg's position to facilitate venous return and to prevent excessive abdominal viscera shift and restriction of the diaphragm that occurs with the head-down position.

Patients and their families are often frightened and anxious. If the patient is awake, provide a running explanation of the procedures to reassure him or her. Hold the patient's hand to offer reassurance when possible. Explain the treatment alternatives to the family and keep them updated as to the patient's response to therapy. If blood component therapy is essential, answer the patient's and family's questions about the risks involved.

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