How does excessive fluid resuscitation impact casualties with internal bleeding?

Excessive fluid resuscitation in casualties with internal bleeding can exacerbate the situation primarily because it can increase intravascular pressure, potentially leading to further bleeding from the site of the injury. When fluids are administered in large volumes, they can dilute blood components, impair coagulation, and create a situation where the body's natural hemostatic processes are overwhelmed. As a result, instead of improving blood flow and circulation effectively, excessive fluids can worsen the hemorrhage, making it harder to control and increasing the risk of complications such as shock. Understanding this concept is critical for managing trauma patients effectively, as it emphasizes the need for careful assessment and controlled administration of fluids to prevent further harm.