C: Circulation

Consider the following points:

  • Are you titrating adrenaline yet?
  • Weigh up whether your patient is best positioned sitting up (breathless) or flat with leg elevation (shocked)
  • Crystalloid not colloid (as colloids are allergenic)
  • Give 1000 ml fluid challenges if the patient is hypotensive; half that in patients with known cardiac failure, listening carefully for lung crepitations in between boluses
  • 4-8 litres of crystalloid may be required in the peri-arrest or arrest case. Worth repeating that: 4-8 litres
  • Consider inserting an arterial line