C/T BP problems

[OzAmbo]

I am curious to those who wanted fluids running in a pt with this sort of cardiac history as to the reasoning behind it, as stated transplant patioens get funky rhythms, the patient was afebrile, hypotensive yes, but really not dangerously so. with the limited resources provided pre-hospital, if this was a cardiac issue, wouldnt overloading with fluids be detrimental to the patient? lets take out the fact we hae been told it was sepsis.

Fluid loading would be detrimental but bearing in mind im sure they didn't transplant a diseased heart with dialated or hypertrophic cardiomyopathy or advanced IHD so your biggest causes of failure are already out of the picture, and given the OP it doesn't really cross me as an MI

The other thought is that this is obsructive shock from PE, pericardial effusion/tamponade/pericarditis in which case she is preload dependent and not giving her fluid could be bad ju ju - given her atypical pain i wonder if there is an element of this

If it is sepsis (well, septic shock at the moment) even a B/P of 90 if she is perfused ok still gives her a mortality approaching 20% as she is hypotensive.

My answer is, given the OP failure is well down my differential dx, and not fluid loading the other possibilities carries far more benefit than risk IMO.