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What Is Emergency Resuscitation?
Emergency resuscitation is the term most commonly used to describe the emergent treatment of the most severely ill and injured patients. Resuscitation is a word derived from the Latin word meaning "to set in motion". To the emergency physician, the term encompasses not only attempts to reanimate those patients in cardiopulmonary arrest, but the treatment of virtually any diseases in the extremes of presentation. Resuscitation is an active process that is intervention-oriented and often invasive. The emergency physician (EP) confronted with a resuscitation must multitask and "set into motion" a team of health care workers which includes nurses, technologists and consultants.
Resuscitation and the Downward Spiral of Disease
Most disease processes move through stages of severity, beginning with an asymptomatic phase and progressing toward their end-stage. Generally speaking, disturbances in one physiologic function lead to disturbances in others and, through a sort of pathologic "multiplier effect", diseases gain momentum as they progress. Diseases that have reached their end-stage often have such momentum that they require intensive and rapid intervention if there is to be any hope of reversing the underlying
pathology. Although patients may present to the emergency department at any stage in the continuum, it is those patients at the bottom of the spiral, those with de-compensated and end-stage disease, that will require resuscitation.
In general, attempts are made to tailor the treatment of a particular patient to the tempo of their disease. The treatment of these processes should ideally occur at a similar pace because abrupt changes may cause additional risk to the patient. Nonetheless, the momentum of end-stage disease will often force the emergency physician to use drastic and potent therapy, and such therapy is usually not without adverse consequences. The effect of the unwanted effects of therapy, together with the powerful and synergistic downward forces of multiply deranged physiologic functions, make resuscitation among the most challenging tasks of the emergency physician.
Emergency resuscitation and infants
Low Apgar score is a major concern in infants these days. Apgar score is useful to examine health of new born babies on the basis of five vital parameters as APGAR (Appearance, Pulse Grimace, Activity and Respiration). Whether a baby requires emergency resuscitation or not depends on its breathing pattern in the first minute after its birth. If the Apgar score is below 7, the situation may demand urgent resuscitation to bring the breathing frequency back to normal.
Emergency resuscitation in infants must be carried out by experts as even a minor flaw in the treatment may lead to death of the infant. Proper ventilation and sufficient provision of oxygen is vital for resuscitation process. Post-resuscitation medication may also be needed in some cases if the desired results are not obtained. There is a limit to use the process of resuscitation for improving the breathing abilities of the baby. If the infant do not respond well even after 10-20 minutes of resuscitation, then the probability of bringing the breath-rate back to normal is quite low but may vary from infant to infant. Experience and expertise counts while treating a patient by resuscitation as the final decision about duration of treatment has to be taken by the doctor carrying out the treatment.
Emergency Resuscitation of Cardiac disorder
People suffering from cardiac arrest may need resuscitation on an urgent basis to prevent jamming in the airway of the patient. Clearance of airway is vital to enable the patient to take oxygen instantaneously and minimize the risk of fall in heart beats. In case the person is unable to take in sufficient amounts of oxygen spontaneously, usage of medical apparatus for supply of oxygen through lungs or mouth-to-mouth transfer of oxygen can also be done.
Cardiopulmonary resuscitation is only a temporary process and not a treatment to restore supply of oxygen to the heart. The main purpose is to ease the flow of oxygen so that tissues do not die or perform inefficiently. Dying out of tissues may result into permanent damage to the brain. Thus, supply of oxygen at the right moment is very important and the process has to be conducted under proper medical supervision.
Emergency resuscitation can be very helpful as a first aid technique to ensure supply of oxygen at the right moment and in right quantities. The method can be effective only if the person gets resuscitation in the first few minutes of shortage of oxygen. Hence, availability of necessary equipments at the medical centre is extremely important.
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