What is the most preferred resuscitation fluid for casualties in shock?

The preferred resuscitation fluid for casualties in shock is cold stored low titer O whole blood because it provides a balanced approach to treating hemorrhagic shock. Whole blood contains red blood cells, plasma, and platelets in their natural proportions, which is crucial for effective resuscitation in trauma cases. The low titer O blood type is particularly valuable because it can be given safely to patients regardless of their blood type, reducing the time needed to match blood types in emergency situations.

Using whole blood provides not only the necessary oxygen-carrying capacity through red blood cells but also essential clotting factors and volume resuscitation from the plasma. This combination supports hemostatic resuscitation, which aims to promote normal blood coagulation and minimize dilutional coagulopathy that can occur when using crystalloid solutions or other blood components like packed red blood cells or plasma alone.

In contrast, other options such as normal saline do not effectively address coagulopathy and can dilute clotting factors, whereas plasma alone lacks the oxygen-carrying capacity of red blood cells. Similarly, red blood cells alone do not provide volume or the necessary clotting components, which are critical for patients experiencing significant blood loss. Thus, the use of cold stored low titer