Peri-resuscitation echocardiography: Training the novice practitioner

Price, Susanna; Ilper, H.; Uddin, Shahana; Steiger, Holger; Seeger, Florian; Schellhaas, Sebastian; Heringer, Frank; Ruesseler, Miriam; Ackermann, Hanns; Via, Gabriele; Walcher, Felix; Breitkreutz, Raoul

doi:10.1016/j.resuscitation.2010.07.001

Cited by 39 publications

(16 citation statements)

References 10 publications

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“…These assumptions were based on previously reported durations of NFIs (31). Based on these assumptions, we determined that we would require 12 groups to detect differences in NFI duration between the first and subsequent scenarios.…”

Section: Discussionmentioning

confidence: 99%

“…However, little is known regarding the most effective method for training providers in POC ultrasonography during arrest scenarios. When simulation is combined with didactics and hands-on training, novice practitioners are able to achieve proficiency in POC ultrasonography during cardiac arrest after a 1-day course (31). It is unclear, however, whether exposure to simulated arrest scenarios improves compliance with the ACLS goal to minimize duration of no-flow intervals (NFIs), periods during which chest compressions are interrupted, pulse and rhythm checks are performed, and POC ultrasonography use is ideal.…”

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confidence: 99%

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Use of Point-of-Care Ultrasonography in Simulation-Based Advanced Cardiac Life Support Scenarios

Cha¹,

Gottschalk²,

Su³

et al. 2018

J Anesth Perioper Med

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Background: Ultrasonography is an effective tool for diagnosing potential reversible aetiologies of cardiac arrest. We developed an educational curriculum for critical care ultrasonography involving multiple sequential cardiac arrest simulation scenarios and assessed the efficacy of participants' performance. Methods: Didactic lectures and hands-on training sessions were provided before participants were divided into simulation teams for a series of five scenarios in which they were instructed to utilize ultrasonography during ongoing advanced cardiac life support (ACLS). Simulation sessions were videotaped and subsequently reviewed for extraction of parameters relating to ACLS adherence and performance of point-of-care ultrasonography examination. The primary outcome was duration of no-flow interval (NFI), the period during which chest compressions are halted and ultrasound examination is typically performed. We also collected data on NFI score (based on simulation team performance during NFI), time from arrest to first chest compressions, time from arrest to defibrillation, and other parameters describing team performance. Results: Fifty-five course participants comprised 12 simulation teams. For all participants, the average NFI was 22.2 s (95% CI, 19.1-25.2) during scenario 1, with declines in duration thereafter (P ≤ 0.004). In subsequent scenarios, an increasing proportion of NFI occurred within the interval of 10 s (P = 0.018). Conclusion: Simulation is an effective teaching modality for critical care ultrasonography. Novice ultrasound users can be taught to perform point-of-care ultrasonography effectively during simulated cardiopulmonary arrest in an ACLS-compliant manner, a finding that may have significant implications for the clinical management of in-hospital cardiac arrest. (Funded by the

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Use of Point-of-Care Ultrasonography in Simulation-Based Advanced Cardiac Life Support Scenarios

Cha¹,

Gottschalk²,

Su³

et al. 2018

J Anesth Perioper Med

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“…45 Courses on focused echocardiographic evaluation in life support (FEEL) teach the novice practitioner how to obtain appropriate views with minimal interruption in chest compressions. 46,47 Breitkreutz et al have documented the prehospital use of FEEL in 100 patients in cardiac arrest. 48 In 35% of those with an ECG diagnosis of asystole, and 58% of those with pulseless electrical activity (PEA), coordinated cardiac motion was detected, and associated with increased survival.…”

Section: Advanced Life Supportmentioning

confidence: 99%

Resuscitation 2010 in review

2011

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“…Multiple groups have proposed basic algorithms for integration of GDE into Advanced Cardiac Life Support (ACLS), 12–14 yet few studies assess feasibility and competency in GDE, leaving many questions unanswered. 15–16 …”

Section: Introductionmentioning

confidence: 99%

Goal-Directed Transthoracic Echocardiography During Advanced Cardiac Life Support

Greenstein

Martin

Rolnitzky

et al. 2015

Simulation in Healthcare: The Journal of the Society for Simulation in Healthcare

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Introduction Goal-directed echocardiography (GDE) is used to answer specific clinical questions which provide invaluable information to physicians managing a hemodynamically unstable patient. We studied perception and ability of housestaff previously trained in GDE to accurately diagnose common causes of cardiac arrest during simulated advanced cardiac life support (ACLS); we compared their results to those of expert echocardiographers. Methods Eleven pulmonary and critical care medicine fellows, seven emergency medicine residents, and five cardiologists board-certified in echocardiography were enrolled. Baseline ability to acquire four transthoracic echocardiography views was assessed and participants were exposed to six simulated cardiac arrests and were asked to perform a GDE during ACLS. Housestaff performance was compared to the performance of five expert echocardiographers. Results Average baseline and scenario views by housestaff were of good or excellent quality 89% and 83% of the time, respectively. Expert average baseline and scenario views were always of good or excellent quality. Housestaff and experts made the correct diagnosis in 68% and 77% of cases, respectively. On average, participants required 1.5 pulse checks to make the correct diagnosis. 94% of housestaff perceived this study as an accurate assessment of ability. Conclusions In an ACLS compliant manner, housestaff are capable of diagnosing management altering pathologies the majority of the time and they reach similar diagnostic conclusions in the same amount of time as expert echocardiographers in a simulated cardiac arrest scenario.

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Peri-resuscitation echocardiography: Training the novice practitioner

Cited by 39 publications

References 10 publications

Use of Point-of-Care Ultrasonography in Simulation-Based Advanced Cardiac Life Support Scenarios

Use of Point-of-Care Ultrasonography in Simulation-Based Advanced Cardiac Life Support Scenarios

Resuscitation 2010 in review

Goal-Directed Transthoracic Echocardiography During Advanced Cardiac Life Support

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