Emergency medicine has focused on the perfusion of the tissues for the past 40 years. Great emphasis is placed on excellent CPR as we move into the new millennium. Push hard and push fast has taken the medical community by storm to say the least. Providing high quality emergency resuscitation care will ensure adequate tissue perfusion. Reversing metabolic acidosis is paramount to restoring circulation to the tissues and preventing cellular death. With poor circulation there is an inevitable outcome. The patient will cease to recover from the cardiac arrest as well as leave the hospital without neurological deficits.

myocardium

Providing an adequate amount of volume will increase the pre-load which in return will elevate the osmotic gradient. By increasing the return of blood to the heart, there is hope that the Brain will receive an adequate amount of oxygenation. Ventilation with a bag valve mask will help to increase inner thoracic pressure to aid in internal gas exchange. Cellular death will ensue if high tertiary level of care is not implemented in a timely manner. Therefore, adequate tissue perfusion is absolutely necessary for successful  resuscitation.