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J Emerg Med. 2019 Apr 16. pii: S0736-4679(19)30100-3. doi: 10.1016/j.jemermed.2019.02.013. [Epub ahead of print]

The POCUS Pulse Check: A Case Series on a Novel Method for Determining the Presence of a Pulse Using Point-of-Care Ultrasound.

Author information

1
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
2
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
3
University of Toronto, Toronto, Ontario, Canada.

Abstract

BACKGROUND:

During cardiopulmonary resuscitation, pulse checks must be rapid and accurate. Despite the importance placed on the detection of a pulse, several studies have shown that health care providers have poor accuracy for detection of central pulses by palpation. To date, the use of point-of-care ultrasound (POCUS) in cardiac arrest has focused on the presence of cardiac standstill and diagnosing reversible causes of the arrest.

OBJECTIVE:

This case series highlights a simple, novel approach to determine whether pulses are present or absent by using POCUS compression of the central arteries.

DISCUSSION:

Using this technique, we found that a POCUS pulse check can be consistently performed in < 5 s and is clearly determinate, even when palpation yields indeterminate results.

CONCLUSIONS:

In this case series, the POCUS pulse check was a valuable adjunct that helped to change management for critically ill patients. Future prospective studies are required to determine the accuracy of this technique and the impact on patient outcomes in a larger cohort.

KEYWORDS:

cardiac arrest; pulse check; ultrasonography

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