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

Resuscitation. 2010 Nov;81(11):1527-33. doi: 10.1016/j.resuscitation.2010.07.013.

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. These reports were then analysed independently.

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). Images of diagnostic quality were obtained in 96%. 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. Echocardiographic findings altered management in 78% of cases.

Conclusions: Application of ALS-compliant echocardiography in pre-hospital care is feasible, and alters diagnosis and management in a significant number of patients. Further research into its effect on patient outcomes is warranted.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Advanced Cardiac Life Support / methods*
  • Aged
  • Algorithms
  • Cardiopulmonary Resuscitation / methods*
  • Echocardiography*
  • Emergency Medical Services / organization & administration*
  • Feasibility Studies
  • Female
  • Heart Arrest / diagnostic imaging*
  • Heart Arrest / therapy*
  • Humans
  • Male
  • Prospective Studies
  • Treatment Outcome