| Rapid cardiac ultrasound of inpatients suffering PEA arrest performed by nonexpert sonographers. | |
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MedLine Citation:
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PMID: 16199290 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cardiac arrest presenting as pulseless electrical activity (PEA) currently has a very low survival rate. Many of the conditions underlying PEA (cardiac tamponade, hypovolemia, and pulmonary embolus) are associated with specific cardiac ultrasound findings. The aim of this study was to evaluate a rapid cardiac ultrasound assessment performed by trained nonexpert sonographers integrated into the ACLS response system at a major medical center. METHODS: An emergency sonography system was created and deployed to each inpatient cardiac arrest occurring at Dartmouth Hitchcock Medical Center between November 1, 2003 and April 30, 2004. Thirteen internal medicine house officers received training to perform a limited subcostal cardiac ultrasound examination designed to diagnose cardiac tamponade, pulmonary embolus, severe hypovolemia, and lack of cardiac motion. Time from arrest alert to sonographic result, and correlation with over-reading by blinded echocardiography physicians were assessed. RESULTS: A complete emergency ultrasound examination was performed in five PEA arrests. The average time from arrest alert to interpretation was 7.75 min. (95% CI 2.8-18.3 min). Three of these examinations (60%, 95% CI 14.7-94.7%) were adequate for interpretation. Agreement between the nonexpert sonographer and echocardiography physician occurred in four of five (kappa=0.706) cases. CONCLUSION: Rapid cardiac sonography can be successfully integrated in the ACLS response. Nonexpert sonographers may be able to provide useful interpretive information when sufficiently trained. |
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Authors:
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Daniel F Niendorff; Athos J Rassias; Robert Palac; Michael L Beach; Salvatore Costa; Mark Greenberg |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Resuscitation Volume: 67 ISSN: 0300-9572 ISO Abbreviation: Resuscitation Publication Date: 2005 Oct |
Date Detail:
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Created Date: 2005-10-03 Completed Date: 2006-01-20 Revised Date: 2009-08-25 |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 81-7 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Dartmouth Hitchcock Medical Center, USA. niendd@kadlecmed.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Allied Health Personnel Cardiac Tamponade / complications, ultrasonography Cardiopulmonary Resuscitation* Clinical Competence Critical Illness Echocardiography, Doppler* Echocardiography, Transesophageal* Emergency Medical Services Emergency Service, Hospital Female Heart Arrest / etiology, mortality, therapy, ultrasonography* Humans Inpatients Life Support Systems Male Middle Aged Pulmonary Embolism / complications, ultrasonography Quality of Health Care Risk Assessment United States Ventricular Fibrillation / etiology, mortality, therapy, ultrasonography* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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