An evaluation of echo in life support (ELS): is it feasible? What does it add?

Hayhurst, Catherine; Lebus, Caroline; Atkinson, Paul; Kendall, Richard; Madan, Rajeev; Talbot, Jo-Ann; Ross, Peter S.; Lewis, David A.

doi:10.1136/emj.2009.084202

Cited by 44 publications

(43 citation statements)

References 11 publications

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“…This enables the clinician to distinguish between PEA and pseudo PEA, and to determine a cardiac cause such as massive pulmonary embolism, cardiac tamponade or severe hypovolaemia. 3,9,10, 13,14,16,18,19 There is insufficient evidence either to support or refute the routine use of ultrasonography to predict the success of resuscitation, 10 although it is has been demonstrated that focused cardiac ultrasonography can be used to define cardiac activity during cardiopulmonary resuscitation. 7, 13,15,16,20 -22 Cardiac ultrasonography has been used as an effective diagnostic tool during cardiac arrest, in particular for determining the causes of PEA and true asystole.…”

Section: Cardiac Ultrasonography and Resuscitation Outcomementioning

confidence: 99%

Assessment of Cardiac Ultrasonography in Predicting Outcome in Adult Cardiac Arrest

et al. 2012

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Section: Cardiac Ultrasonography and Resuscitation Outcomementioning

confidence: 99%

Assessment of Cardiac Ultrasonography in Predicting Outcome in Adult Cardiac Arrest

et al. 2012

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“…However, in the earlier study, out of 59 patients with no cardiac activity, 2 had survived. Several other studies have been published during the last two decades with similar findings of poor outcome associated with cardiac standstill, but most of them still reported ROSC incidence in a small number of patients with cardiac standstill [39][40][41][42]. One of the highest survivals of patients with no wall motion was reported by Breitkreutz et al in 2010 wherein a total of five (10%) out of 50 patients with no cardiac movement survived [28].…”

Section: Identification Of Cardiac Standstillmentioning

confidence: 82%

Bedside ultrasound in cardiac standstill: a clinical review

et al. 2019

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Patients with cardiac arrest present as a relatively frequent occurrence in the Emergency Department. Despite the advances in our understanding of the pathophysiology of cardiac arrest, managing the condition remains a stressful endeavor and currently implemented interventions, while beneficial, are still associated with a disappointingly low survivability. The majority of modern Advanced Life Support algorithms employ a standardized approach to best resuscitate the 'crashed' patient. However, management during resuscitation often encourages a 'one-size-fitsall' policy for most patients, with lesser attention drawn towards causality of the disease and factors that could alter resuscitative care. Life support providers are also often challenged by the limited bedside predictors of survival to guide the course and duration of resuscitation. Over the recent decades, point-of-care ultrasonography (PoCUS) has been gradually proving itself as a useful adjunct that could potentially bridge the gap in the recognition and evaluation of precipitants and end-points in resuscitation, thereby facilitating an improved approach to resuscitation of the arrested patient. Point-of-care ultrasound applications in the critical care field have tremendously evolved over the past four decades. Today, bedside ultrasound is a fundamental tool that is quick, safe, inexpensive and reproducible. Not only can it provide the physician with critical information on reversible causes of arrest, but it can also be used to predict survival. Of note is its utility in predicting worse survival outcomes in patients with cardiac standstill, i.e., no cardiac activity witnessed with ultrasound. Unfortunately, despite the increasing evidence surrounding ultrasound use in arrest, bedside ultrasound is still largely underutilized during the resuscitation process. This article reviews the current literature on cardiac standstill and the application of bedside ultrasound in cardiac arrests.

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“…Focused ultrasonography is already being taught for use in cardiac arrest, though this is largely limited to investigating for potential reversible causes of pulseless electrical activity, such as tamponade and pulmonary embolism 13. Studies have already considered the incorporation of ultrasonography into ALS protocol: finding it feasible and with evidence it could guide patient management 14 15…”

Section: Discussionmentioning

confidence: 99%

Apparent asystole: are we missing a lifesaving opportunity?

Limb

Siddiqui

2015

BMJ Case Reports

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The use of ultrasonography is rapidly expanding in emergency medicine. Real-time assessment offers clues to prompt diagnosis and creates opportunities for speedy intervention. We present a case of ‘cardiac monitor asystole’ that proved to be ventricular fibrillation on ultrasound examination. Uniquely this case demonstrates that this, typically unrecognised, form of ventricular fibrillation responds to desynchronised defibrillation, with restoration of perfusion for approximately 30 min. With increasing access to ultrasound we believe that further research is indicated to determine whether some cases of apparent asystole may best be treated by defibrillation, presenting an opportunity to save more lives than current protocols achieve.

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An evaluation of echo in life support (ELS): is it feasible? What does it add?

Abstract: It is concluded that ELS is feasible and that the scan findings may guide further interventions.

Cited by 44 publications

References 11 publications

Assessment of Cardiac Ultrasonography in Predicting Outcome in Adult Cardiac Arrest

Assessment of Cardiac Ultrasonography in Predicting Outcome in Adult Cardiac Arrest

Bedside ultrasound in cardiac standstill: a clinical review

Apparent asystole: are we missing a lifesaving opportunity?

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