Echocardiography In OOHCA

Question 1

Opportunities for POCUS in CA

Answer 1

Optimise CPR
Identify CAS phenotype
Enhanced diagnostics
Prognostication
TOE

Question 2

EMD

Answer 2

Electromechanical dissociation
Some ecg activity, agonal slow PEA,
no cardiac movement, no aortic valve opening, cardiac standstill

Question 3

NCOS

Answer 3

No cardiac output state
Some mechanical activity, no pulsatility, no ejection, arterial line flat

Question 4

ELCOS

Answer 4

Extremely low cardiac output state
Fast narrow ECG
Coordinated but severely impaired contraction
Aortic valve opening
Very low pressures
May hold off cpr while addressing underlying cause

Question 5

What diagnostic assessments can be made with POCUS in CA

Answer 5

Hypovolaemia
Pericardial effusion
Pleural space pathology
Lung sliding
FAST scan
Transitioning clot
Thrombi
Hypertrophic cardiomyopathy
Acute mitral regurgitation
Aortic dissection
HOCM
AVRD
Decision making in Thrombolysis

Question 6

What is the most pulsatile structure on USS during CA

Answer 6

Venous system

Question 7

Why is TOE easier during CA than transthoracic

Answer 7

Doesn’t interrupt chest compressions