Abstract
The purpose of this study was to evaluate a rapid cardiac ultrasound assessment performed
by trained non-expert sonographers integrated into the advanced cardiac life support
(ACLS).
Material and methods
This study was prospectively performed in 179 patients (104 males and 75 females)
who underwent cardiopulmonary resuscitation (CPR) in an emergency department (ED)
during two calendar years (2013 and 2014). Two senior doctors, who had received emergency
cardiac ultrasonography training, performed cardiac ultrasound through the apical,
subxiphoid, or parasternal windows. Ultrasound evaluation and pulse controls were
performed simultaneously. SPSS 18.0 was used for statistical analysis.
Results
A total of 63.7% (114) of the cardiopulmonary arrest incidents occurred out of the
hospital. Only 13 patients had a femoral pulse during the initial evaluation, while
166 showed no femoral pulse. Initial monitoring showed a regular rhythm in 53 patients,
ventricular fibrillation in 18 patients, and no rhythms in 108 patients. The first
evaluation with ultrasound detected an effective heart rate in 26 patients and ventricular
fibrillation in 14 patients, while no effective heart rate was observed in 139 patients.
In addition, ultrasound revealed pericardial tamponade in seven patients and right
ventricular enlargement in four cases. Global hypokinesia was detected in four patients
and hypovolemia was observed in another four patients.
Conclusion
The use of real-time ultrasonography during resuscitation with real-time femoral pulse
check can help facilitate the distinguishing of pea-type arrest, ascertain the cause
of the arrest, infer a suitable treatment, and optimize medical management decisions
regarding CPR termination.
Keywords
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Article info
Publication history
Published online: March 05, 2016
Accepted:
February 25,
2016
Received in revised form:
February 15,
2016
Received:
September 8,
2015
Footnotes
☆A Spanish translated version of the summary of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2016.02.025.
Identification
Copyright
© 2016 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
