Ultrasound: a potential new approach for cardiac arrest management
Walker, Eoin
Walker, Eoin
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Abstract
Abstract published with permission.
Introduction: Out-of-Hospital Cardiac Arrest (OHCA) is a common occurrence within
the pre- hospital environment (approximately 10,000 OHCA in London - over one third
of England’s national total of 28000; BHF 2015). The management can be associated
with difficult decision-making. Ultrasound (US) has recently been introduced to
critical care practice, yet evidence is poor around this topic in relation to OHCA.
Search strategy: All cardiac arrest empirical literature within the last 15 years
on US both in-hospital and pre-hospital. Discussion: Sensitivity analyses within
OHCA in comparison with current practice show US is more accurate in predicting
mortality than it is in predicting survivability to hospital admission or discharge.
US is therefore well placed as a tool for cardiac arrest management alongside End
Tidal Carbon Dioxide (ETCO2) monitoring and Electrocardiogram (ECG) findings,
as none have the benefit of being a linear marker of survival. Conclusion:
Recommendations show that US should form part of critical care management
in OHCA as a sensitive real time marker of kinetic ventricular activity. This is
alongside other markers of cardiac output, all of which carry variable levels of
sensitivity (ECG, ETCO2) to best inform the advanced paramedic practitioner.