Sandbox

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