What is the maximum amount of Hextend that should be given to a casualty pre-hospital?

• A. 1000 mL
• B. 500 mL
• C. 1500 mL
• D. 2000 mL

Answer: (A)

In prehospital care under TCCC, the goal is to restore perfusion quickly while avoiding the risks that come with large-volume resuscitation. Hextend is a 6% hetastarch plasma volume expander used to raise circulating volume, but the field dose is limited to 1,000 mL. Exceeding this amount increases the risk of dilutional coagulopathy, electrolyte imbalances, kidney concerns, and can delay rapid evacuation and definitive care. Therefore, the maximum amount you should administer before arriving at the hospital is 1,000 mL. If perfusion remains inadequate after that, prioritize hemorrhage control and rapid evacuation, with additional fluid or blood products handled in-hospital as appropriate.