Stabilisation of the emergency patient Part II: Circulation

Abstract

Stabilisation of the emergency patient follows the ABC (airway-breathing-circulation protocol). Following the stabilisation of respiration and provision of oxygen-saturated blood, perfusion must be ensured. Perfusion is evaluated according to heart rate, pulse quality and rate, mucous membrane colour and capillary refill time, and temperature. Shock is defined as decreased perfusion leading to hypoxia. Depending on the cause and pathophysiologic processes, hypovolemic, obstructive, distributive or cardiogenic shock can be differentiated. All lead to a decrease in cardiac output, followed by decreased perfusion of tissues and subsequent cellular hypoxia. Therapy includes oxygen supplementation, fluid resuscitation with bolus therapy of isotonic crystalloid or colloid solutions, analgesia and haemorrhage control. Intensive monitoring is required for successful stabilisatio