 Management of hypovolemic shock involves immediate control of external hemorrhage, volume resuscitation or plans for the control of inaccessible hemorrhage or then for those plasma losses. Now whilst the aim of volume resuscitation is to return to normal tension, permissive hypotension which refers to controlled volume resuscitation may prevent further bleeding. It is hypothesized that the increase in blood pressure through aggressive volume resuscitation may dislodge thrombi leading to bleeding. Now in the case of profound hypovolemic shock though, aggressive volume resuscitation is required irrespective of this hypothesis. Rapid volume resuscitation is optimized by inserting two 16 gauge or larger peripheral short intravenous catheters. Volume resuscitation can not be done through long thin central lines. By the laws of physics, keep them thick and short for maximum flow. Also try to avoid the femoral veins as insertion of catheters here leads to a higher incidence of infection and venous thrombosis. If they use was necessary, try and replace them as soon as possible. Always consider the viscosity of the administered fluid and please always watch out for any kinks in the lines. Secure them with care and check repeatedly. It is easy to get distracted during an acute resuscitation. Now there is a drive towards the use of balanced salt solutions such as ringers lactate in favor of normal 0.9% saline which is not physiological and it can actually worsen the metabolic acidosis associated with hypovolemic shock. A total of 2 to 3 liters may be given in 10 to 30 minutes. This may represent 3 to 4 times the blood volume loss. If a patient does not respond to such volumes, ongoing losses may be occurring or another form of shock may be present. The hemorrhagic shock may necessitate the use of blood and blood products. Monitoring the adequacy of volume resuscitation is most important. The cerebrum is most sensitive to a decrease in perfusion. Successful volume resuscitation should see an improvement in the patient's mental state. The blood pressure should rise and the heart rate and pulse pressure should decrease. Skin color may return especially if you transfuse the patient with packed cells and finally urine output may increase.