Ultrasound use during cardiopulmonary resuscitation is associated with delays in chest compressions

POCUS在急救時會被用來:找尋可治療的原因、輔助氣管插管的確認和評估預後等。
(急診超音波的新進展)
這篇小型的研究指出一個重要的事實: 
POCUS的執行會延長Puse check的時間達8.4秒
有POCUS進行時的Pulse check時間平均為:21秒
無POCUS進行時的Pulse check時間平均為:13秒
因此,急救時執行POCUS,必須要規劃和確實執行,
才能減少不必要的延遲和中斷CPR的進行。

AIM:

High-quality chest compressions are a critical component of the resuscitation of patients in cardiopulmonary arrest. Point-of-care ultrasound (POCUS) is used frequently during emergency department (ED) resuscitations, but there has been limited research assessing its benefits and harms during the delivery of cardiopulmonary resuscitation (CPR). We hypothesized that use of POCUS during cardiac arrest resuscitation adversely affects high-quality CPR by lengthening the duration of pulse checks beyond the current cardiopulmonary resuscitation guidelines recommendation of 10s.

METHODS:

We conducted a prospective cohort study of adults in cardiac arrest treated in an urban ED between August 2015 and September 2016. Resuscitations were recorded using video equipment in designated resuscitation rooms, and the use of POCUS was documented and timed. A linear mixed-effects model was used to estimate the effect of POCUS on pulse check duration.

RESULTS:

Twenty-three patients were enrolled in our study. The mean duration of pulse checks with POCUS was 21.0s (95% CI, 18-24) compared with 13.0s (95% CI, 12-15) for those without POCUS. POCUS increased the duration of pulse checks and CPR interruption by 8.4s (95% CI, 6.7-10.0 [p<0.0001]). Age, body mass index (BMI), and procedures did not significantly affect the duration of pulse checks.

CONCLUSIONS:

The use of POCUS during cardiac arrest resuscitation was associated with significantly increased duration of pulse checks, nearly doubling the 10-s maximum duration recommended in current guidelines. It is important for acute care providers to pay close attention to the duration of interruptions in the delivery of chest compressions when using POCUS during cardiac arrest resuscitation.

Source:

Ultrasound use during cardiopulmonary resuscitation is associated with delays in chest compressions.

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