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! Acidosis !! Preexisting acidosis, DM, diarrhea, drugs and toxins, prolonged resuscitation, renal disease, shock !! Reassess adequacy of oxygenation, and ventilation; reconfirm endotracheal-tube placement  !!  !!  !!  !!  !!  !!  !!
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|| || Hyperventilate || || || || ||  ||  ||
| ! Acidosis !! Preexisting acidosis, DM, diarrhea, drugs and toxins, prolonged resuscitation, renal disease, shock !! Reassess adequacy of oxygenation, and ventilation; reconfirm endotracheal-tube placement !! !! !! !! !! !! !!
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|  ||  || Consider intravenous bicarbonate if pH <7.20 after above actions have been taken  ||  ||  ||  ||  ||  ||  ||  
| |-
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| Cardiac tamponade || Hemorrhagic diathesis, cancer, pericarditis, trauma, after cardiac surgery or MI || Give fluids; obtain bedside echocardiogram ||  ||  ||  ||  ||  ||  ||  
| | || || Hyperventilate ||  ||  ||  ||  ||  ||  ||  
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|  ||  || Perform pericardiocentesis. Immediate surgical intervention is appropriate if pericardiocentesis is unhelpful but cardiac tamponade is known or highly suspected.  ||  ||  ||  ||  ||  ||  ||  
| |-
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| Hypothermia || Alcohol abuse, burns, CNS  disease, debilitated or elderly patient, drowning, drugs and toxins, endocrine disease, history of exposure, homelessness, extensive skin disease, spinal cord disease, trauma || If severe (temperature <30°C), limit initial shocks for V-Fib or pulseless V-Tach to three; initiate active internal rewarming and cardiopulmonary support. Hold further resuscitation medications or shocks until core temperature is >30°C.  ||  ||  ||  ||  ||  ||  ||  
| | || || Consider intravenous bicarbonate if pH <7.20 after above actions have been taken ||  ||  ||  ||  ||  ||  ||  
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| ||  || If moderate (temperature 30-34°C), proceed with resuscitation (space medications at intervals greater than usual), actively rewarm truncal body areas  ||  ||  ||  ||  ||  ||  ||
| |-
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| Hypovolemia, hemorrhage, anemia || Major burns, DM, GI losses, hemorrhage, hemorrhagic diathesis, cancer, pregnancy, shock, trauma || Give fluids  ||  ||  ||  ||  ||  ||  ||  
| | Cardiac tamponade || Hemorrhagic diathesis, cancer, pericarditis, trauma, after cardiac surgery or MI || Give fluids; obtain bedside echocardiogram ||  ||  ||  ||  ||  ||  ||  
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|  ||  || Transfuse pRBCs if hemorrhage or profound anemia is present  ||  ||  ||  ||  ||  ||  ||  
| |-
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|  ||  || Thoracotomy is appropriate when patient has cardiac arrest from penetrating trauma and a cardiac rhythm and the duration of cardiopulmonary resuscitation before thoracotomy is <10 min  ||  ||  ||  ||  ||  ||  ||  
| |  ||  || Perform pericardiocentesis. Immediate surgical intervention is appropriate if pericardiocentesis is unhelpful but cardiac tamponade is known or highly suspected.  ||  ||  ||  ||  ||  ||  ||
|-
| |-
|-
| | Hypothermia || Alcohol abuse, burns, CNS  disease, debilitated or elderly patient, drowning, drugs and toxins, endocrine disease, history of exposure, homelessness, extensive skin disease, spinal cord disease, trauma || If severe (temperature <30°C), limit initial shocks for V-Fib or pulseless V-Tach to three; initiate active internal rewarming and cardiopulmonary support. Hold further resuscitation medications or shocks until core temperature is >30°C.  ||  ||  ||  ||  ||  ||  ||
|-
| |-
|-
| |  ||  || If moderate (temperature 30-34°C), proceed with resuscitation (space medications at intervals greater than usual), actively rewarm truncal body areas  ||  ||  ||  ||  ||  ||  ||
|-
| |-
|-
| | Hypovolemia, hemorrhage, anemia || Major burns, DM, GI losses, hemorrhage, hemorrhagic diathesis, cancer, pregnancy, shock, trauma || Give fluids  ||  ||  ||  ||  ||  ||  ||
|-
| |-
|-
| |  ||  || Transfuse pRBCs if hemorrhage or profound anemia is present  ||  ||  ||  ||  ||  ||  ||
|-
| |-
|-
| |  ||  || Thoracotomy is appropriate when patient has cardiac arrest from penetrating trauma and a cardiac rhythm and the duration of cardiopulmonary resuscitation before thoracotomy is <10 min  ||  ||  ||  ||  ||  ||  ||  
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Revision as of 20:34, 31 May 2023

{| class="wikitable"
! Acidosis !! Preexisting acidosis, DM, diarrhea, drugs and toxins, prolonged resuscitation, renal disease, shock !! Reassess adequacy of oxygenation, and ventilation; reconfirm endotracheal-tube placement  !!  !!  !!  !!  !!  !!  !!
-
Hyperventilate
-
Consider intravenous bicarbonate if pH <7.20 after above actions have been taken
-
Cardiac tamponade Hemorrhagic diathesis, cancer, pericarditis, trauma, after cardiac surgery or MI Give fluids; obtain bedside echocardiogram
-
Perform pericardiocentesis. Immediate surgical intervention is appropriate if pericardiocentesis is unhelpful but cardiac tamponade is known or highly suspected.
-
Hypothermia Alcohol abuse, burns, CNS disease, debilitated or elderly patient, drowning, drugs and toxins, endocrine disease, history of exposure, homelessness, extensive skin disease, spinal cord disease, trauma If severe (temperature <30°C), limit initial shocks for V-Fib or pulseless V-Tach to three; initiate active internal rewarming and cardiopulmonary support. Hold further resuscitation medications or shocks until core temperature is >30°C.
-
If moderate (temperature 30-34°C), proceed with resuscitation (space medications at intervals greater than usual), actively rewarm truncal body areas
-
Hypovolemia, hemorrhage, anemia Major burns, DM, GI losses, hemorrhage, hemorrhagic diathesis, cancer, pregnancy, shock, trauma Give fluids
-
Transfuse pRBCs if hemorrhage or profound anemia is present
-
Thoracotomy is appropriate when patient has cardiac arrest from penetrating trauma and a cardiac rhythm and the duration of cardiopulmonary resuscitation before thoracotomy is <10 min
}