Replenish 360 (R360)’s parent company, Palm Desert Resuscitation Education LLC (PDRE), provides high-quality and professional training and certification in Basic Life Support (BLS), Advanced Cardiac Life Support (ALCS), Pediatric Advance Life Support (PALS), Neonatal Resuscitation Program (NRP) and other specialized and innovated instructions and curriculum for healthcare professionals as well as non-medical lay persons. The importance of prevention of cardiopulmonary arrest is the chief point that PDRE stresses upon when it comes to providing these basic and advanced resuscitation lessons and curriculums. However, the primary assessments and surveys utilized for ACLS, PALS, and NRP for instance are essential in integration to any fluid resuscitation attempt for unstable patients, more importantly, as well as preventative measures for healthy individuals who are just mildly to moderately dehydrated from their normal daily activities and life’s challenges in not being able to hydrate sufficiently and appropriately in a consistent manner. The latter, of course, is what Replenish 360 (R360)’s main goal desperately and enthusiastically desires to resolve in our plush and relaxing IV Hydration Therapy Clinics and/or out-of-site comprehensive wellness referral services. The former, however, is interesting to note to say the least.
Specifically, for conscious or semi-conscious patients who have hemodynamic instability the primary assessment survey of “ABCDE” (Airway, Breathing, Circulation, Disability/Differential Diagnosis, and Exposure) describes “Circulation” or “C” as one of the algorithms needed for effective cardiopulmonary resuscitation and explicitly points towards fluid resuscitation for any compromised circulatory and vascular systems. Obviously, the advance healthcare provider’s initial impression will require immediate “at or from the door” evaluation of the patient’s current medical condition as either a respiratory, cardiac, shock, and/or life threatening issue in order to provide the best, most appropriate, and initial medical and clinical intervention(s). For instance, if the patient’s initial appearance illustrates someone who is in respiratory distress or arrest with other grave symptoms such as pale skin, dry mucosal membranes, abnormal skin turgor, and increased capillary refill from a quick targeted physical examination; point-of-care vital signs suggesting hemodynamic instability, stark dehydration, and shock in a patient who is severely hypotensive, tachycardic/bradycardic, tachypneic/apneic, hypoxic, and hypothermic; his or her medical history proposes any degree of desiccation from severe nausea causing vomiting or retching, decreased oral intake of food and fluids, watery diarrhea, excessive blood loss, and other multitude causes of dehydration etiologies; and in addition to non-reassuring diagnostic testing, such as deviant electrocardiography (ECG) findings, then obvious and immediate fluid resuscitation and advance life support is indicated and, if delayed, may cause cardiac arrest, organ failure, long-term debilitation and death as stated previously in some cases.
Here are a few fundamental fluid resuscitation interventions for the different age groups that does not account for individual and unique medical and clinical histories in combination with modifiable and non-modifiable risk factors for fluid hydration requirements:
|AGE GROUPS||SYSTOLIC BP (INIDICATIVE OF SEVERE HYPOTENSION)||IV/IO/CENTRAL LINE/ET TUBE/UMBILICAL VENOUS CATHFLUID|
|TYPE OF CRYSTALLOID FLUIDS USED INITIALLY (PREFERRED)|
|Adults**||< 90 mmHg||1 – 2 Liters (L)||Isotonic|
|Children***||70 + (2 x Age) mmHg||20 ml/kg||Isotonic|
|Infants****||< 70 mmHg||20 ml/kg||Isotonic|
|Neonates*****||< 60 mmHg||10 ml/kg||Isotonic|
*IV = Intravenous; IO = Intraosseous; ET = Endotracheal tube
**At least pubertal stage and older defines the adult age group demographic
***From one year old to puberty defines the children age group demographic
****From 30 days old to one year old defines the infant age group demographic
***** From birth to 30 days old defines the neonatal age group demographic