<prompt> Patient with massive hemorrhage presents to the ER after A. Whats not to be done?Massive transfusion of fluid challengeIV crystalloid 2L, within few minutesEarly tranexamic acid recommendedCheck coagulation with thromboelastography, if available  <response>: - ATLS updates 2018: Give only 1 liter of warm isotonic crystalloids for adults old edition recommended 1-2 liters of warm crystalloid solution - ATLS updates 2018: In children 40kg, give 20mlkg of warm isotonic crystalloids The initial resucitation with crystalloid fluid still begins with a 1 litre bolus of warmed isotonic fluid.Early control of external hemorrhage is pivotal to the management of the injured patient. Thromboelastography and rotational thromboelastometry are helpful when available to pinpoint the precise ocagulation deficiency. CRASH-2 Trial ATLS updates 2018 - Use of tranexamic acid in hypotensive trauma patients 