Ultrasound Podcast 196 – Cardiac Arrest with Cian McDermott, Part 1
This week we get to hear from Cian McDermott, ED physician extraordinaire on his approach to cardiac arrest. In this podcast we discuss 1 vs 2 person POCUS, different ways to use it during arrest, and some of our favorite published protocols. There was so much great content in this interview, so I decided to break it up into 2 podcasts. This week features part 1! (Click here for Part 2)
Look down below for the show notes, courtesy of Cian McDermott!
Important topic – why?
work in ED see several OOHCA per week
my service 3 to 5 per week
10 – 15% survival rate in best centres (Danish 15 yr study)
can we manage this better using POCUS?
Concept has been around but lots of new literature in 3 years
POCUS is not for shockable rhythm
put down the transducer and give electricity!
conside for reversible arrest only = PEA, asystole (5Hs & 5Ts)
2 user levels
Level I user – most ppl
US during pulse check only
maybe confirm asystole at end
first time I saw POCUS in code like this was in Australia in 2014
may have been to EGLS course
looking for reversible causes
tamponade, signs RV strain then cardiac activity
SubX or PSLA view
starts before the end of CPR to minimise delays
What does the evidence say?
ACLS from 2015 cites a single study and they recommend that US may be used during an arrest, they give class II evidence for this
I had to hunt on the website to find this – ACLS are ‘lukewarm’
ACLS will be updated in 2020 so I’m waiting to see what changes are recommended
European and American Society produced guidelines on use of POCUS