Cardiac Arrest, Out-Of-Hospital
Conditions
Keywords
Cardiac Arrest, Out-of-hospital Cardiac Arrest, OHCA, Ultrasound, Point-Of-Care Ultrasound, POCUS, Pulse Check, POCUS Pulse Check, B-mode Ultrasound, Femoral Artery, Arterial Compressibility Assessment
Brief summary
The goal of this prospective observational study is to investigate B-mode point-of care ultrasound with arterial compressibility assessment on the femoral artery as a method to determine the presence of a pulse and to compare it with concurrently conducted manual pulse checks.
Detailed description
In this prospective observational study, a dedicated research team will be dispatched to cardiac arrest patients treated in the prehospital environment by emergency medical services (EMS). The team will use a portable ultrasound device to identify the femoral artery and employ B-mode ultrasound during rhythm checks. These ultrasound pulse checks will be conducted in parallel with the normal treatment of the patient, including manual pulse checks, and will only be conducted if ultrasound is possible without interference in the resuscitation. All treatment decisions will rest with the treating EMS team.
Interventions
OTHERPoint of Care Ultrasound
Point-of-care ultrasound will be used to image the femoral vessels and to assess the presence or absence of a pulse and the compressibility of the artery during rhythm checks.
Sponsors
Ludwig Boltzmann Institute Digital Health and Patient Safety
Emergency Medical Service of Vienna
Medical University of Vienna
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* Out-of-hospital cardiac arrest treated by EMS * Minimum age of 18 years
Exclusion criteria
* Pregnancy or suspected pregnancy * Disapproval of the treating EMS team * Adults under legal guardianship * Inability to perform femoral artery doppler ultrasound due to limited access to the patient and possible interference with the treating EMS team * Inability to perform femoral artery doppler ultrasound due to injuries or anatomic abnormalities in the femoral region or necessary emergent medical interventions in the femoral region * Decision to transfer the patient to the hospital with ongoing CPR for emergent procedures such as extracorporeal CPR before femoral artery doppler ultrasound could be attempted * Inability to safely perform femoral artery doppler ultrasound due to environmental hazards
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Results of POCUS pulse check | During cardiac arrest, up to 45 minutes | If the femoral artery is both non-compressible and pulsatile, the POCUS pulse check will be considered positive |
| Results of the concurrently conducted manual pulse check | During cardiac arrest, up to 45 minutes | Parallel to our study team the treating team will conduct standard care, consisting of determining the presence or absence of a pulse by palpation. The results of these manual pulse checks will be recorded by our study team. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Arterial compressibility during chest compressions | During cardiac arrest, up to 45 minutes | Before each pulse check, during the last 30 seconds of cardiac compressions, the research team will apply pressure with the ultrasound probe until complete collapse of the femoral vein and visually assess if the neighbouring femoral is compressible as well. |
| Arterial compressibility during rhythm checks | During cardiac arrest, up to 45 minutes | The compressibility of the femoral artery during rhythm checks (part of the POCUS pulse check primary outcome) will be recorded and analysed, independently of pulsatility |
| Arterial pulsatility during rhythm checks | During cardiac arrest, up to 45 minutes | The pulsatility of the femoral artery during rhythm checks (part of the POCUS pulse check primary outcome) will be recorded and analysed, independently of compressibility |
| Time needed for POCUS pulse checks | During cardiac arrest, up to 45 minutes | The POCUS pulse checks will be recorded and the time until presence or absence of a pulse could be determined will be recorded in seconds |
Countries
Austria
Contacts
Primary ContactPhilipp Metelka, MD
Backup ContactChristina Hafner, MD, PhD
Outcome results
None listed