1. Detection of Traumatic Complications of Cardiopulmonary Resuscitation by Ultrasound
- Author
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Corbett, Stephen W. and O'Callaghan, Thomas
- Subjects
CPR (First aid) -- Usage ,Cardiac patients -- Usage ,Health - Abstract
Byline: Stephen W Corbett, Thomas O'Callaghan Abstract: Study objective: We conducted a pilot study to assess the feasibility of ultrasonography in the detection of traumatic complications of CPR. Methods: A prospective case series was undertaken with a convenience sample of 21 emergency department patients who sustained nontraumatic cardiopulmonary arrest. A 5- to 7-minute ultrasound examination was performed during resuscitation. The presence or absence of free fluid was noted in the left and right upper quadrants, coronal views of the kidneys, the pelvis, and the pericardium; autopsies to determine the source of fluid were not performed. Cardiac activity and the concurrent electrical rhythm were also noted. All ultrasonographers had previously been trained in the use of this technique for the evaluation of trauma patients. Examinations were stored on videotape for further review. Results: Seven of 20 patients (29%) had findings on ultrasound that could have resulted from CPR-related trauma. In one additional case, findings of free fluid were probably the result of preexisting illness (ascites). Pericardial effusion was found in three patients, perihepatic fluid in four, pleural fluid in one, perirenal fluid in four, perisplenic fluid in two, and pelvic fluid in three; several patients had multiple findings. Cardiac motion with pulseless electrical activity was noted in seven patients. Five patients had return of spontaneous circulation and survived to hospitalization, and one survived to discharge. Conclusion: Traumatic complications of CPR are well known but typically difficult to assess. Ultrasonography may identify injuries, help guide procedures, and serve as a means to assess pharmacologic effects on cardiac performance during CPR. It is a readily available, noninvasive means to assess these critically ill patients. [Corbett SW, O'Callaghan T: Detection of traumatic complications of cardiopulmonary resuscitation by ultrasound. Ann Emerg Med March 1997;29:317-322.] Article History: Received 25 March 1996; Revised 8 August 1996; Accepted 13 August 1996 Article Note: (footnote) [star] From the Departments of Emergency Medicine* and Surgerya , Loma Linda University Medical Center, Loma Linda, California., [star][star] Reprint no.47/1/79387 , a Address for reprints: Stephen W Corbett, MD Department of Emergency Medicine Loma Linda University Medical Center 11234 Anderson Street PO Box 2000 Loma Linda, California 92534 909-824-4344 Fax 909-478-4121
- Published
- 1997