What is the recommended initial fluid bolus for a patient with ST-segment elevation and hypotension?

The recommended initial fluid bolus for a patient with ST-segment elevation and hypotension is 30 mL/kg of normal saline. This volume is considered appropriate to achieve adequate intravascular volume, which is especially crucial in cases of hypotension associated with conditions like ST-segment elevation myocardial infarction (STEMI).

In such scenarios, rapid fluid resuscitation is needed to restore blood pressure and improve perfusion to vital organs. A bolus of 30 mL/kg provides a substantial volume that typically supports hemodynamic stability by helping to increase stroke volume and cardiac output. It is essential to monitor the patient's response closely, as fluid needs can vary based on individual circumstances, especially considering the risks of fluid overload.

This guideline aligns with current resuscitation protocols, which emphasize the importance of early and aggressive volume resuscitation in patients presenting with hypotension due to conditions like STEMI. Choosing a bolus that is too low could lead to inadequate resuscitation, while very high volumes may pose unnecessary risks of complications.