The PoCUS Pulse Check 2021 - or better a direct cardiac view?
Interesting concept, - not proven to be ALS-conformed yet, but potential for this - not evaluating for possible underlying causes of cardiac arrest. - no outcome data for this method. However, it is easy to perform (and MUCH better that manual pulse checks!!). Clips can be downloaded and used as #FOAMed for free education....;-)
Interesting concept,
- not proven to be ALS-conformed yet, but potential for this
- not evaluating for possible underlying causes of cardiac arrest.
- no outcome data for this method.
However, it is easy to perform (and MUCH better that manual pulse checks!!).
Clips can be downloaded and used as #FOAMed for free education....;-)
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WINFOCUS W<strong>or</strong>ld Congress <strong>2021</strong><br />
“Pandemic and beyond” June 12-13 th , <strong>2021</strong><br />
<strong>The</strong> <strong>PoCUS</strong> <strong>Pulse</strong> <strong>Check</strong><br />
(Part of a congress lecture)<br />
Raoul Breitkreutz<br />
(Frankfurt & Bad Rappenau, Germany)<br />
www.winfocus.<strong>or</strong>g
PEA <strong>or</strong> EMD?<br />
<strong>The</strong> EMD was abandoned m<strong>or</strong>e than ..20.. years ago<br />
PEA n=4<br />
EMD n=0<br />
precisely because of the presumption that clinicians were<br />
unable to assess <strong>cardiac</strong> activity during resuscitations.<br />
Since that time, the w<strong>or</strong>ld has been plagued with the<br />
waste-basket term PEA, which encompasses both pulseless<br />
patients with EMD (who are often unresuscitatable)<br />
and those with <strong>cardiac</strong> activity and no palpable pulses<br />
Problem term<br />
Pulsless<br />
Electrical <br />
Activity<br />
(who are much m<strong>or</strong>e likely to achieve ROSC).<br />
With the increasing prevalence of clinical sonography in<br />
the periresuscitation setting allowing immediate assessment<br />
of <strong>cardiac</strong> activity, we can return to the utilitarian EMD<br />
and drop PEA into a linguistic dust bin, where it belongs.
Q: How accurate are manual<br />
pulse checks?
Novel concepts
<strong>The</strong> <strong>PoCUS</strong> <strong>Pulse</strong> <strong>Check</strong><br />
15 CA pulse clips, evaluation on the internet, claim to detect perfusion<br />
interobserver reliability: >0,8 (in all subgroups)<br />
HCP: 15min w<strong>or</strong>kshop, Carotid pulse detection in live subjects was not<br />
slower using US as compared to palpation
<strong>Pulse</strong> <strong>Check</strong>s<br />
Comparison of Palpation - Sonoscopy<br />
Edited by Raoul Breitkreutz (<strong>2021</strong>)<br />
Scientific Netw<strong>or</strong>k SonoABCD<br />
<strong>The</strong> fine art of Sonoscopy.
„<strong>The</strong> <strong>PoCUS</strong> <strong>Pulse</strong> <strong>Check</strong>“ -<br />
Focused evaluation of artery<br />
probe positioning<br />
compression<br />
evaluate wall motion<br />
positive exam: pulse present<br />
Edited by Raoul Breitkreutz (<strong>2021</strong>)<br />
Scientific Netw<strong>or</strong>k SonoABCD<br />
<strong>The</strong> fine art of Sonoscopy.
negative exam: no pulse
„<strong>The</strong> <strong>PoCUS</strong> <strong>Pulse</strong> <strong>Check</strong>“<br />
ALS-conf<strong>or</strong>mity<br />
Positive Exam<br />
- non-compressible artery<br />
not collapsed <br />
- wall motion - pulsatil<br />
possible (to be proven,
Isn´t a <strong>direct</strong> <strong>cardiac</strong> <strong>view</strong> also<br />
a pulse check?<br />
Two real life studies<br />
137 CA victims, Cardiac Evaluation (CUSG) superi<strong>or</strong><br />
to Doppler Ultrasound (DUSG) <strong>or</strong> manual pulse palpation<br />
Edited by Raoul Breitkreutz (<strong>2021</strong>)<br />
102 non-traumatic CA victims, expansion of <strong>Pulse</strong> criteria supp<strong>or</strong>t CUSG<br />
when et CO2 increase, <strong>or</strong>ganized EKG-rhythm are added<br />
carotid pulse checks <strong>better</strong> than fem<strong>or</strong>al
Quick <strong>PoCUS</strong> checks and Resume CC
Summary<br />
• Easy to apply, novel method, categ<strong>or</strong>y „Resuscitation<br />
Ultrasound“, potential of ALS-conf<strong>or</strong>mity<br />
• Option f<strong>or</strong> health-care providers, Step-in method of <strong>PoCUS</strong>.<br />
to training basics of ultrasound principles.<br />
• No „outcome data“: method must not be overinterpreted yet<br />
• ALS-conf<strong>or</strong>med evaluation of the heart, e.g. with the FEEL<br />
exam, also is a „<strong>Pulse</strong> <strong>Check</strong>“. However, it has also the<br />
Edited by Raoul Breitkreutz (<strong>2021</strong>)<br />
potential to identify treatable conditions of <strong>cardiac</strong> arrest<br />
• all <strong>PoCUS</strong> interventions categ<strong>or</strong>y „Resuscitation<br />
Ultrasound“, must proof ALS-conf<strong>or</strong>mity, if to be used in<br />
CPR! (see ERC <strong>2021</strong> guidelines, <strong>PoCUS</strong> statements)
WINFOCUS W<strong>or</strong>ld Congress <strong>2021</strong><br />
“Pandemic and beyond” June 12-13 th , <strong>2021</strong><br />
<strong>The</strong> <strong>PoCUS</strong> <strong>Pulse</strong> <strong>Check</strong><br />
(Part of a congress lecture)<br />
Raoul Breitkreutz<br />
(Frankfurt & Bad Rappenau, Germany)<br />
www.winfocus.<strong>or</strong>g
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