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Focused echocardiographic evaluation in life support and peri-resuscitation of emergency patients: A prospective trial.

Resuscitation, 2010


[Epub ahead of print] Focused echocardiographic evaluation in life support and peri-resuscitation of emergency patients: A prospective trial.
Abstract PURPOSE OF THE STUDY: Focused ultrasound is increasingly used in the emergency setting, with an ALS-compliant focused echocardiography algorithm proposed as an adjunct in peri-resuscitation care (FEEL).
The purpose of this study was to evaluate the feasibility of FEEL in pre-hospital resuscitation, the incidence of potentially treatable conditions detected, and the influence on patient management.
PATIENTS, MATERIALS AND METHODS: A prospective observational study in a pre-hospital emergency setting in patients actively undergoing cardio-pulmonary resuscitation or in a shock state.
The FEEL protocol was applied by trained emergency doctors, following which a standardised report sheet was completed, including echo findings and any echo-directed change in management.
RESULTS: A total of 230 patients were included, with 204 undergoing a FEEL examination during ongoing cardiac arrest (100) and in a shock state (104).
In 35% of those with an ECG diagnosis of asystole, and 58% of those with PEA, coordinated cardiac motion was detected, and associated with increased survival.
CONCLUSIONS: Application of ALS-compliant echocardiography in pre-hospital care is feasible, and alters diagnosis and management in a significant number of patients.
Review Focused echocardiographic evaluation in resuscitation management: concept of an advanced life support-conformed algorithm.
Derivation and evaluation of a termination of resuscitation clinical prediction rule for advanced life support providers.