The POCUS Pulse Check: A Case Series on a Novel Method for Determining the Presence of a Pulse Using Point-of-Care Ultrasound

Simard, Robert; Unger, Andrea G.; Betz, Martin; Wu, Alison; Chenkin, Jordan

doi:10.1016/j.jemermed.2019.02.013

Cited by 17 publications

(13 citation statements)

References 14 publications

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“…1 Manual central pulse checks are unreliable and may erroneously miss the presence of a pulse or fail to recognize the absence of one. [2][3][4][5] Point-of-care ultrasound is a noninvasive technique to visualize the heart and central vessels during resuscitation. 4,6 It can help determine the presence or absence of cardiac activity in conjunction with, or instead of, manual pulse checks, as is demonstrated in case 1.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

“…Conversely, in the presence of central perfusion, the artery will be noncompressible with pulsations visualized on ultrasound. 5 Badra et al 4 demonstrated that POCUS carotid pulse checks are not slower than those using palpation and demonstrated a higher first-attempt success rate. A femoral pulse may be easily accessible by POCUS during both compressions and during the pulse and rhythm check in a pediatric patient, as was demonstrated in case 2.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

“…7,9 Point-of-care ultrasound can also be used to assess for quality of compressions and for central pulses during pulse and rhythm checks in the femoral or carotid locations. 4,5 In pulseless patients, neither arterial nor venous vasculature will have blood flow; thus, it will compress easily as the transducer is used to apply pressure to the skin. Conversely, in the presence of central perfusion, the artery will be noncompressible with pulsations visualized on ultrasound.…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

“…Cardiac arrest is an infrequent but high-stakes scenario in pediatrics 1 . Manual central pulse checks are unreliable and may erroneously miss the presence of a pulse or fail to recognize the absence of one 2–5 . Point-of-care ultrasound is a noninvasive technique to visualize the heart and central vessels during resuscitation 4,6 .…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

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Point-of-Care Ultrasound for Pulse Checks in Pediatric Cardiac Arrest

2022

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Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

See 2 more Smart Citations

Point-of-Care Ultrasound for Pulse Checks in Pediatric Cardiac Arrest

2022

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“…Point-of-care ultrasound can also be used to assess for quality of compressions and for central pulses during pulse and rhythm checks in the femoral or carotid locations. 4,5 In pulseless patients, arterial and venous vasculature will not have blood flow; thus, both will compress easily because the transducer is used to apply pressure to the skin. Conversely, in the presence of central perfusion, the artery will be noncompressible with pulsations visualized on ultrasound.…”

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confidence: 99%

The Feasibility of Using Point-of-Care Ultrasound During Cardiac Arrest in Children

et al. 2022

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IntroductionResuscitation guidelines emphasize minimal interruption of compressions during cardiopulmonary resuscitation. Point-of-care ultrasound (POCUS) enables the clinician to visualize cardiac contractility and central artery pulsatility. The apical 4-chamber (A4), subxiphoid (SX), and femoral artery views may be used when defibrillator pads or active compressions preclude parasternal cardiac views. We hypothesized that clinicians can rapidly obtain interpretable POCUS views in healthy children from the A4, SX, and femoral positions.MethodsA prospective study of pediatric emergency medicine providers in an urban academic hospital was performed. Stable patients of 12 years or younger were scanned. Sonologists were each allotted 10 seconds to acquire A4, SX, and femoral views. Two attempts at each view were allowed. The primary outcome was whether cardiac and femoral artery scans were interpretable for contractility and pulsatility, respectively. The secondary outcome was whether cardiac scans were interpretable for effusion or right ventricular strain. A POCUS expert reviewed scans to confirm interpretability.ResultsTwenty-two sonologists performed a total of 50 scans on 22 patients. A view that was interpretable for contractility was obtained on the first attempt in 86% of A4 and 94% of SX scans. A femoral view that was interpretable for pulsatility was obtained on the first attempt in 74% of scans. Expert review was concordant with sonologist interpretation.ConclusionsPediatric emergency medicine physicians can obtain interpretable cardiac and central artery views within 10 seconds most of the time. Point-of-care ultrasound has the potential to enhance care during pediatric resuscitation. Future studies on the impact of POCUS pulse checks in actual pediatric resuscitations should be performed.

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Questionnaire survey on point‐of‐care ultrasound utilization during cardiac arrest among emergency physicians in Hong Kong

Lo,

Kwok,

Suen

2024

Hong Kong j. emerg. med.

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IntroductionAlthough point‐of‐care ultrasound (POCUS) is recognized as a useful diagnostic and prognostic tool during the management of out‐of‐hospital cardiac arrest (OHCA), opposing viewpoints exist. The objectives of this study are to investigate the knowledge, attitude, and practice (KAP) in POCUS utilization during OHCA among emergency medicine (EM) physicians in Hong Kong and to identify their barriers.MethodsA cross‐sectional questionnaire was conducted among EM physicians in 9 accident and emergency departments in Hong Kong. The questionnaire assessed participants' demographics, knowledge, attitude, practices, and barriers on this issue. Composite scores for KAP were calculated. Subgroup analysis and multiple regression analysis were used to explore the correlation between KAP and participants' demographics. Participants' barriers were evaluated by binary and open‐ended questions.ResultsA total of 224 questionnaires were distributed and 150 questionnaires were returned (response rate: 67.0%). Statistically significant associations of knowledge and attitude with practice were demonstrated (both p < 0.001). Independent predictors of more frequent POCUS use in OHCA included EM fellowship status (p = 0.005), receiving training on this issue (p < 0.001), and working in large hospitals (p = 0.007). The top‐ranked barriers were chaotic environment (74%), no structural education on this practice (63%), and the lack of staff (61%).ConclusionsThe knowledge and attitude of performing POCUS during OHCA were demonstrated to enhance EM physicians' practice. By improving physicians' knowledge and removing the possible barriers they are facing, POCUS can be optimally utilized during OHCA to improve patient care.

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The POCUS Pulse Check: A Case Series on a Novel Method for Determining the Presence of a Pulse Using Point-of-Care Ultrasound

Cited by 17 publications

References 14 publications

Point-of-Care Ultrasound for Pulse Checks in Pediatric Cardiac Arrest

Point-of-Care Ultrasound for Pulse Checks in Pediatric Cardiac Arrest

The Feasibility of Using Point-of-Care Ultrasound During Cardiac Arrest in Children

Questionnaire survey on point‐of‐care ultrasound utilization during cardiac arrest among emergency physicians in Hong Kong

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