Resuscitation

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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.

Contents

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, rresuscitation 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]

Variables

SystemExample causesBiomarkerTreatment
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

References

  1. ↑ Montagna, Sara; Croatti, Angelo; Ricci, Alessandro; Agnoletti, Vanni; Albarello, Vittorio; Gamberini, Emiliano (2020). "Real-time tracking and documentation in trauma management". Health Informatics Journal . 26 (1): 328–341. doi:10.1177/1460458219825507. ISSN   1460-4582. PMID   30726161.
  2. ↑ Cheung, Kin; Yip, Chak Sum (2024-01-05). "Documentation Completeness and Nurses' Perceptions of a Novel Electronic App for Medical Resuscitation in the Emergency Room: Mixed Methods Approach". JMIR mHealth and uHealth . 12: e46744. doi: 10.2196/46744 . ISSN   2291-5222. PMC   10799286 . PMID   38180801.
  3. ↑ Gostmann, Björn; Rogge, Grigori (2025). "Resuscitation Documentation: Mobility and Efficiency through Tablet-Based Solutions". ATLAS Digitale Gesundheitswirtschaft.
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