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

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

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1
Department of Anaesthesiology, Intensive Care and Pain Therapy University of the Saarland, Medical Faculty, D-66421 Homburg (Saar), Germany. raoul.breitkreutz@gmail.com

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.

[Indexed for MEDLINE]

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