title: Benefits of cardiac sonography performed by a non-expert sonographer in patients with non-traumatic cardiopulmonary arrest.
abstract: The purpose of this study was to evaluate a rapid cardiac ultrasound assessment performed by trained non-expert sonographers integrated into the advanced cardiac life support (ACLS).
  
  
  METHODS
  This study was prospectively performed in 179 patients (104 males and 75 females) who underwent cardiopulmonary resuscitation (CPR) in an emergency department (ED) during two calendar years (2013 and 2014). Two senior doctors, who had received emergency cardiac ultrasonography training, performed cardiac ultrasound through the apical, subxiphoid, or parasternal windows. Ultrasound evaluation and pulse controls were performed simultaneously. SPSS 18.0 was used for statistical analysis.
  
  
  RESULTS
  A total of 63.7% (114) of the cardiopulmonary arrest incidents occurred out of the hospital. Only 13 patients had a femoral pulse during the initial evaluation, while 166 showed no femoral pulse. Initial monitoring showed a regular rhythm in 53 patients, ventricular fibrillation in 18 patients, and no rhythms in 108 patients. The first evaluation with ultrasound detected an effective heart rate in 26 patients and ventricular fibrillation in 14 patients, while no effective heart rate was observed in 139 patients. In addition, ultrasound revealed pericardial tamponade in seven patients and right ventricular enlargement in four cases. Global hypokinesia was detected in four patients and hypovolemia was observed in another four patients.
  
  
  CONCLUSIONS
  The use of real-time ultrasonography during resuscitation with real-time femoral pulse check can help facilitate the distinguishing of pea-type arrest, ascertain the cause of the arrest, infer a suitable treatment, and optimize medical management decisions regarding CPR termination.
authors.affiliation: Department of Emergency Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey. Electronic address: zengins76@gmail.com.
authors.forename: Suat
authors.initials: S
authors.lastname: Zengin
authors.affiliation: Department of Emergency Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey.
authors.forename: Erdal
authors.initials: E
authors.lastname: Yavuz
authors.affiliation: Department of Emergency Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey.
authors.forename: Behçet
authors.initials: B
authors.lastname: Al
authors.affiliation: Department of Emergency Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey.
authors.forename: Şener
authors.initials: Ş
authors.lastname: Cindoruk
authors.affiliation: Department of Cardiology, Gaziantep University School of Medicine, Gaziantep, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Altunbaş
authors.affiliation: Department of Emergency Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Gümüşboğa
authors.affiliation: Department of Emergency Medicine, Gaziantep University School of Medicine, Gaziantep, Turkey.
authors.forename: Cuma
authors.initials: C
authors.lastname: Yıldırım
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000488:Allied Health Personnel; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002983:Clinical Competence; D004452:Echocardiography; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cardiac sonography; Cardiopulmonary arrest; Cardiopulmonary resuscitation; Pulseless electrical activity