Saturday, July 14, 2018

Echo in Cardiac Arrest

R.E.B.E.L.EM - July 13, 2018
Background: Focused use of ultrasound in resuscitation of patients with shock and cardiac arrest has become increasingly embraced in both the emergency department (ED) as well as in the prehospital setting. Application of ultrasound, particularly of echocardiography, has the potential to identify treatable causes of shock and arrest, identify shockable rhythms and identify the presence of mechanical activity. All of these can affect management decisions and, potentially effect outcomes. Recent studies have led to concerns that integration of point of care ultrasound (POCUS) in cardiac arrest increases pauses in compressions. Thus, it is important to establish what POCUS adds to shock and arrest management...
Bottom Line:
POCUS is a powerful tool in cardiac arrest care but is only useful if the information obtained from it is acted upon. In a small number of cases, cardiac ultrasound will reveal potentially reversible pathology in the cardiac arrest patient. Lastly, it is clear that fingers are not accurate in assessing the presence or absence of a pulse in patients in extremis. It’s time to abandon fingers for the pulse check and embrace more advanced technology."