Primary treatment should be directed at the cause (morphine or a 250ml fluid challenge).

The initial volume expansion period is called the fluid challenge, and may be distinguished from succeeding maintenance administration of fluids.

During the fluid challenge, large amounts of fluids may be administered over a short period of time under close monitoring to evaluate the patient's response.

In the event of hypotension and/or lactate greater than 4 mmol/L, initial management includes a minimum fluid challenge of 30 ml/kg of crystalloid solution.