Guiding Cardiopulmonary Resuscitation with Focused Echocardiography: A Report of Five Cases
| Autor: | Christopher L. Moore, Connie Y Yu, James M. Daley, Sharmin Kalam, David C. Cone, Charles R. Wira, Rachel Liu, Evie G. Marcolini, Sandy Bogucki |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Resuscitation Emergency Medical Services medicine.medical_treatment Hemodynamics 030204 cardiovascular system & hematology Emergency Nursing 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Cardiopulmonary resuscitation Aged Aged 80 and over business.industry Visually guided Point of care ultrasound Advanced cardiac life support 030208 emergency & critical care medicine Middle Aged End tidal Cardiopulmonary Resuscitation Heart Arrest Physical performance Echocardiography Emergency Medicine Cardiology Female business |
| Zdroj: | Prehospital emergency care. 24(2) |
| ISSN: | 1545-0066 |
| Popis: | Background: Focused transthoracic echocardiography has been used to determine etiologies of cardiac arrest and evaluate utility of continuing resuscitation after cardiac arrest. Few guidelines exist advising ultrasound timing within the advanced cardiac life support algorithm. Natural timing of echocardiography occurs during the pulse check, when views are unencumbered by stabilization equipment or vigorous movements. However, recent studies suggest that ultrasound performance during pulse checks prolongs the pause duration of cardiopulmonary resuscitation. Transesophageal echocardiography studies have demonstrated benefits in this regard, but there have been no transthoracic echocardiography studies assessing the physical performance of compressions during cardiopulmonary resuscitation. Objective: The purpose of this study was to describe cases where echocardiography performed at the beginning of the cardiac arrest algorithm offers actionable information to cardiopulmonary resuscitation itself without delaying provision of compressions. Conclusion: Providers using focused echocardiography to evaluate cardiac arrest patients should consider initiating scans at the start of compressions to identify the optimal location for compression delivery and to detect inadequate compressions. Subsequent visualization of full left ventricular compression may be seen after a location change, and combined with end tidal carbon dioxide values, gives indication for improved forward circulatory flow. Although it is not possible in all patients, doing so hastens provision of quality compressions that affect hemodynamic parameters without causing prolongations to the pulse check pause. Further research is needed to determine patient outcomes from both out-of-hospital and in-hospital cardiac arrest when cardiopulmonary resuscitation is visually guided by focused echocardiography. |
| Databáze: | OpenAIRE |
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