<prompt> Which of the following should be avoided initially in hemorrhagic shock: March 2011Ringer lactateDextrose 5Normal salineNone of the above  <response>: Ans. B: Dextrose 5 Hypotonic solutions e.g. dextrose are poor volume expanders and should not be used in the treatment of shock unless the deficit is free water loss e.g. diabetes insipidus or patients are sodium overloaded e.g. cirrhosis Glucose containing solutions should not be used in shock they exacerbate ischaemic brain damage 