Wednesday, April 3, 2019

Pulse Checks in Cardiac Arrest

R.E.B.E.L.EM - By Salim Rezaie - March 28, 2019
..."Author Conclusion:“The use of real-time CUSG during resuscitation provides a substantial contribution to the resuscitation team. CUSG will allow earlier and more accurate detection of pulse than manual pulse palpation and DUSG.”
ClinicalTake Home Point: Manual pulse palpation alone can result in incorrect decisions in management of cardiac arrest patients and should stop being used in clinical practice as it is not sensitive or specific for pulses in cardiac arrest. DUSG is a nice secondary modality compared to CUSG but can have false positives and negatives for pulse detection. Some institutions have started using TEE, which would be the optimal tool for the job, however the majority of ED providers do not have access to TEE so it seems, in appropriately trained providers, CUSG > DUSG > Manual Palpation would be the preferred modalities, in descending order, for pulse detection in cardiac arrest."