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.
Documentation For subsequent treatment, resuscitations have to be properly recorded. 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.
Variables
SystemExample causesBiomarker TreatmentHypoperfusion (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 cellsCardiogenic shock Cardiac output Positive inotropic agents / ChronotropesDistributive shock Sepsis (Septic shock) Vascular permeabilityVasopressors Neurogenic shock Total peripheral resistanceObstructive shock Cardiac tamponade Beck's triad Pericardiocentesis/Thoracotomy with pericardial window Tension pneumothorax Thoracentesis/Chest drain Pulmonary embolism Thrombolysis/EmbolectomyAcid–base imbalance AcidosispHSodium bicarbonate AlkalosisInterventional/SupportiveGas exchange (Respiratory failure) HypercapniaPaCO2Interventional/Supportive HypoxiaPaO2Oxygen therapy Altered level of consciousness Coma Narcosis (Drug overdose) / Stroke (Intracranial hemorrhage)Glasgow Coma ScaleInterventional/SupportiveBlood sugar regulation HyperglycemiaBlood sugarInsulin HypoglycemiaGlucoseElectrolyte imbalance HyperkalemiaSerum potassiumCalcium chloride/Calcium diglutamate, others HypokalemiaPotassium Coagulopathy HypocoagulabilityCoagulation screen Fresh frozen plasma/Cryoprecipitate/Platelets
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