Resuscitation

 ( Critical Emergency Medicine ) 

Resuscitation is the process of correcting physiological disorders (such as lack of breathing or heartbeat) in an acutely ill patient. It is an important part of intensive care medicine, anesthesiology, trauma surgery and emergency medicine. Well-known examples are cardiopulmonary resuscitation and mouth-to-mouth resuscitation.

Adequate resuscitation and end-organ perfusion is best indicated by urine output of 0.5-1 mL/kg/h. For the average adult male weighing ~70 kg this would mean a urine output of 35 mL/h (70 x 0.5 = 35 mL/h). Heart rate, mental status, and capillary refill may be affected by underlying disease processes and are thus less reliable markers for adequate resuscitation.

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Documentation For subsequent treatment, resuscitations have to be properly Medical record. One example is trauma care. Even though there is a strong expansion of electronic health records, within the healthcare industry, resuscitation documentation is still often handwritten, increasing the risk of incomplete documentation. Novel options like tablet-based solutions help to digitalize this process. For improved documentation quality, future solutions have to be accepted by clinicians and well-integrated into their workflows.

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Variables

Hypoperfusion (Circulatory shock)	Haemorrhagic shock	Hypovolemia (Hypovolemic shock)	Intravascular volume status (Preload)	Heart rate (Tachycardia) / Systolic blood pressure (Hypotension) / Decreased urine output	Intravenous fluid / Intraosseous infusion / Blood transfusion with packed red blood cells
	Cardiogenic shock		Cardiac output		Positive inotropic agents /
	Distributive shock	Sepsis (Septic shock)	Vascular permeability		Vasopressors
		Neurogenic shock	Total peripheral resistance
	Obstructive shock	Cardiac tamponade	Beck's triad		Pericardiocentesis/Thoracotomy with pericardial window
		Tension pneumothorax			Thoracentesis/Chest drain
		Pulmonary embolism			Thrombolysis/Embolectomy
Acid–base imbalance	Acidosis		pH		Sodium bicarbonate
	Alkalosis				Interventional/Supportive
Gas exchange (Respiratory failure)	Hypercapnia		PaCO2		Interventional/Supportive
	Hypoxia		PaO2		Oxygen therapy
Altered level of consciousness	Coma	Narcosis (Drug overdose) / Stroke (Intracranial hemorrhage)	Glasgow Coma Scale		Interventional/Supportive
Blood sugar regulation	Hyperglycemia		Blood sugar		Insulin
	Hypoglycemia				Glucose
Electrolyte imbalance	Hyperkalemia		Serum potassium		Calcium chloride/Calcium diglutamate, others
	Hypokalemia				Potassium
Coagulopathy	Hypocoagulability		Coagulation screen		Fresh frozen plasma/Cryoprecipitate/

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See also

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