Resuscitation in the context of Mouth-to-mouth resuscitation


Resuscitation in the context of Mouth-to-mouth resuscitation

⭐ Core Definition: 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.

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.

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Resuscitation in the context of Intensive care

Intensive care medicine, usually called critical care medicine, is a medical specialty that deals with seriously or critically ill patients who have, are at risk of, or are recovering from conditions that may be life-threatening. It includes providing life support, invasive monitoring techniques, resuscitation, and end-of-life care. Doctors in this specialty are often called intensive care physicians, critical care physicians, or intensivists.

Intensive care relies on multidisciplinary teams composed of many different health professionals. Such teams often include doctors, nurses, physical therapists, respiratory therapists, and pharmacists, among others. They usually work together in intensive care units (ICUs) within a hospital.

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Resuscitation in the context of Drowning

Drowning is a type of suffocation induced by the submersion of the mouth and nose in a liquid. Submersion injury refers to both drowning and near-miss incidents. Most instances of fatal drowning occur alone or in situations where others present are either unaware of the victim's situation or unable to offer assistance. After successful resuscitation, drowning victims may experience breathing problems, confusion, or unconsciousness. Occasionally, victims may not begin experiencing these symptoms until several hours after they are rescued. An incident of drowning can also cause further complications for victims due to low body temperature, aspiration, or acute respiratory distress syndrome (respiratory failure from lung inflammation).

Drowning is more likely to happen when spending extended periods near large bodies of water. Risk factors for drowning include alcohol use, drug use, epilepsy, minimal swim training or a complete lack of training, and, in the case of children, a lack of supervision. Common drowning locations include natural and man-made bodies of water, bathtubs, and swimming pools.

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Resuscitation in the context of Birth asphyxia

Perinatal asphyxia (also known as neonatal asphyxia or birth asphyxia) is the medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain. It remains a serious condition which causes significant mortality and morbidity. It is also the inability to establish and sustain adequate or spontaneous respiration upon delivery of the newborn, an emergency condition that requires adequate and quick resuscitation measures. Perinatal asphyxia is also an oxygen deficit from the 28th week of gestation to the first seven days following delivery. It is also an insult to the fetus or newborn due to lack of oxygen or lack of perfusion to various organs and may be associated with a lack of ventilation. In accordance with WHO, perinatal asphyxia is characterised by: profound metabolic acidosis, with a pH less than 7.20 on umbilical cord arterial blood sample, persistence of an Apgar score of 3 at the 5th minute, clinical neurologic sequelae in the immediate neonatal period, or evidence of multiorgan system dysfunction in the immediate neonatal period. Hypoxic damage can occur to most of the infant's organs (heart, lungs, liver, gut, kidneys), but brain damage is of most concern and perhaps the least likely to quickly or completely heal. In more pronounced cases, an infant will survive, but with damage to the brain manifested as either mental, such as developmental delay or intellectual disability, or physical, such as spasticity.

It results most commonly from antepartum causes like a drop in maternal blood pressure or some other substantial interference with blood flow to the infant's brain during delivery. This can occur due to inadequate circulation or perfusion, impaired respiratory effort, or inadequate ventilation. Perinatal asphyxia happens in 2 to 10 per 1000 newborns that are born at term, and more for those that are born prematurely. WHO estimates that 4 million neonatal deaths occur yearly due to birth asphyxia, representing 38% of deaths of children under 5 years of age.

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Resuscitation in the context of Critical emergency medicine

Critical emergency medicine (CREM) refers to the acute medical care of patients who have medical emergencies that pose an immediate threat to life, irrespective of location. In particular, the term is used to describe the role of anaesthesiologists in providing such care.

The term was introduced in 2010 in a position paper by the Scandinavian Society of Anaesthesiology and Intensive Care Medicine, who defined it as "immediatelife support and resuscitation of critically ill and injured patients in the pre-hospital as well as hospital settings". It describes the roles and competencies of anaesthesiologists and intensive care physicians in caring for patients with life-threatening illness or injury who require resuscitation or support of their vital functions, particularly in Scandinavia and other parts of Europe. One reason the term was introduced was to distinguish these core activities from the broader internationally recognised medical specialty of emergency medicine; the latter deals with the acute care of a broad range of minor to major medical problems that present to an emergency department,.

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Resuscitation in the context of Emergency physician

An emergency physician is a physician who specializes in emergency medicine. They typically work in the emergency department of a hospital and provide care to patients requiring urgent medical attention. Their scope of practice includes advanced cardiac life support (or advanced life support in Europe), resuscitation, trauma care (such as treatment of fractures and soft tissue injuries), and management of other life-threatening conditions. Alternative titles for this role include emergency medicine physician, emergentologist, ER physician, or ER doctor (with ER standing for an emergency room, primarily used in the United States).

In some European countries (e.g. Germany, Belgium, Poland, Austria, Denmark and Sweden), emergency physicians or anaesthetists are also part of the emergency medical service. They are dispatched together with emergency medical technicians and paramedics in cases of potentially life-threatening situations such as serious accident or injury, unconsciousness, heart attack, cardiac arrest, stroke, anaphylaxis, or drug overdose. In the United States, emergency physicians are mostly hospital-based, but also work on air ambulances and mobile intensive care units.

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Resuscitation in the context of Lifesaving

Lifesaving is the act involving rescue, resuscitation and first aid. It often refers to water safety and aquatic rescue; however, it could include ice rescue, flood and river rescue, swimming pool rescue and other emergency medical services. Lifesaving also refers to sport where lifesavers compete based on skills, technique, speed and teamwork. Lifesaving activities specialized in oceanic environment is called surf lifesaving or coastal lifesaving.

Those who participate in lifesaving activities as a volunteer are called lifesavers, and those who are employed to professionally perform lifesaving activities are called lifeguards. Surf lifesaving is a particularly common application. Lifesaving can also be developed as an aquatic sport.

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