At the start of resuscitation, what fraction of the shock dose should be given?

• A. 1/4
• B. 1/2
• C. 3/4
• D. All

Answer: (A)

In resuscitation, you want to restore perfusion quickly but without overshooting and causing fluid overload. The plan is to give a small initial test bolus of the shock dose to see how the patient responds before committing the full amount.

Giving a quarter of the shock dose first allows you to assess the hemodynamic response (blood pressure, signs of perfusion) and adjust if needed. If the patient improves, you can continue with the remaining ¾ of the dose; if not, you escalate or modify therapy. For adults, the typical shock-dose volume is around 2 liters of crystalloid, so starting with about 500 mL (1/4) is the reasoned approach. Fractional dosing helps balance rapid resuscitation with minimizing risk of fluid overload.