Ultrasound: A potential new approach for cardiac arrest management

Eoin Walker
Thursday, March 2, 2017

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.

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