Predictive utility of cardiac ultrasound in traumatic cardiac arrest in a combat casualty.
We report a case of traumatic cardiac arrest in a combat casualty who was resuscitated to return of spontaneous circulation despite asystole and no visible cardiac activity on initial ultrasound examination. This return of spontaneous circulation suggests that survival may be possible in traumatic cardiac arrest due to exsanguination, even when there is no demonstrable cardiac activity on ultrasound. Cardiac ultrasonography was performed for 10 s only. We suggest that cardiac ultrasonography should be performed for a minimum of 1 min during volume resuscitation. If absence of cardiac activity is confirmed once the heart is full, and there are no other signs of life (including pupillary reaction), then termination of resuscitation should be considered.
Department of Anaesthetics, Queens Medical Centre, Nottingham, UK.
Rex
R
Kinnear-Mellor
University Hospital of South Manchester, Manchester, UK.
K
K
Newton
Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, Birmingham, UK.
T
T
Woolley
Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK.
R
R
Rickard
D000328:Adult; D000346:Afghanistan; D000673:Amputation, Traumatic; D001753:Blast Injuries; D004452:Echocardiography; D017809:Fatal Outcome; D006323:Heart Arrest; D006801:Humans; D008297:Male; D008889:Military Personnel; D012151:Resuscitation / Q000379:methods*; D013916:Thrombelastography; D055815:Young Adult
ACCIDENT & EMERGENCY MEDICINE; ULTRASONOGRAPHY