Academic Emergency Medicine
Background and Objectives: Point-of-care ultrasound (POCUS) is frequently used in cardiac arrest to determine cardiac activity, guide resuscitation, and make medical decisions. Currently there is no agreed upon sonographic definition of cardiac activity, potentially leading to inconsistent interpretation of images in clinical practice. The primary objective of our study was to determine emergency physicians use of a definition of cardiac activity, and if a standardized definition would be desired. We also analyzed how providers use POCUS, apply their findings, and their level of confidence in utilizing ultrasound in this patient population. Methods: A review of the POCUS literature identified varying definitions of cardiac activity and used to create a cross-sectional convenience survey. All (73) emergency medicine attendings, fellows, and residents from the Medical College of Wisconsin Affiliated Hospitals Emergency Medicine program were invited to complete an online survey about definitions of cardiac activity, POCUS use, scanning techniques, and confidence when evaluating a patient in cardiac arrest. Descriptive statistics and Spearman correlations of survey data generated with IBM® SPSS® 24.0. Results: A total of 45 of 73 participants (62%) participated. Fortythree (96%) used POCUS to assess patients during cardiac arrest. Most POCUS use occurred during pulse checks (84%) to assess for the presence or absence of cardiac activity, however, there was no consensus definition of cardiac activity among participants. There was a weak correlation (rs = 0.248, p = 0.108) between provider confidence (median (interquartile range) = 7.0 (2.0), max = 10) and determining cardiac activity. Eighty-nine percent believe a standard definition would be helpful. Conclusion: Most providers use POCUS during cardiac arrest and to assess for cardiac activity, yet there is no agreed upon definition. A standard definition of cardiac activity would improve clinical decisionmaking and provider confidence with POCUS in cardiac arrest.
Scheels W, Phelan M, Treat R, Muradian M, Kopatich D. Point-of-care ultrasound cardiac activity definition. Acad Emerg Med. 2021 May;28(suppl. 1):S356.