Abstract
Background
During cardiopulmonary resuscitation, pulse checks must be rapid and accurate. Despite
the importance placed on the detection of a pulse, several studies have shown that
health care providers have poor accuracy for detection of central pulses by palpation.
To date, the use of point-of-care ultrasound (POCUS) in cardiac arrest has focused
on the presence of cardiac standstill and diagnosing reversible causes of the arrest.
Objective
This case series highlights a simple, novel approach to determine whether pulses are
present or absent by using POCUS compression of the central arteries.
Discussion
Using this technique, we found that a POCUS pulse check can be consistently performed
in < 5 s and is clearly determinate, even when palpation yields indeterminate results.
Conclusions
In this case series, the POCUS pulse check was a valuable adjunct that helped to change
management for critically ill patients. Future prospective studies are required to
determine the accuracy of this technique and the impact on patient outcomes in a larger
cohort.
Keywords
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Article info
Publication history
Published online: April 16, 2019
Accepted:
February 17,
2019
Received in revised form:
November 24,
2018
Received:
April 8,
2018
Footnotes
Streaming video: Five brief real-time video clips that accompany this article are available in streaming video at www.journals.elsevierhealth.com/periodicals/jem. Click on Video Clips 1–5.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
