Weak, primarily observational evidence suggests that standard fluid resuscitation has no significant mortality benefit over restricting/withholding IV fluids in the context of severe/hypotensive trauma.

This review adds evidence to questioning the requirement for IV fluids in trauma given the lack of mortality benefit, in addition to demonstrating the need for more randomized studies in this area.

This review holds important implications for research by identifying the need for randomized trials evaluating the effect of prehospital IV fluids in trauma patients.

If undertaken, these trials should compare the prehospital administration of standard dose IV fluids to administering no fluid in patients with severe trauma (similarly to this review, defined as a SI > 1 or sBP < 90 mmHg).

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