Resuscitation

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.

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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.

Documentation

For subsequent treatment, resuscitations have to be properly recorded. One example is trauma care.^[1] 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.^[2] For improved documentation quality, future solutions have to be accepted by clinicians and well-integrated into their workflows.^[3]

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System	Example causes	Biomarker	Treatment
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 / Chronotropes
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/Platelets

See also

Look up resuscitation in Wiktionary, the free dictionary.

Advanced life support – Life-saving protocols
Advanced cardiac life support – Emergency medical care
Advanced trauma life support – American medical training program
Cardiopulmonary resuscitation – Emergency procedure after sudden cardiac arrest
Emergency Preservation and Resuscitation – Experimental emergency medicine procedure
Fluid replacement, also known as Fluid resuscitation – Medical practice of replenishing bodily fluid
Hs and Ts – Mnemonic
Mouth-to-mouth resuscitation – Artificial ventilation using exhaled air from the rescuer
Neonatal resuscitation – An emergency medical procedure
Pediatric advanced life support – American Heart Association course

Documentation

Variables

See also

References

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