Page 178 - Ultrasonography in Prehospital and Emergency Medicine - Rein Ketelaars

Observation
number of US examinations (%)
176
Chapter 8
Table 8.3 Findings of echocardiography
Cardiac dimensions Ventricular filling
good poor
no filling
LV dilatation RV dilatation Could not assess
Global cardiac function good
moderate
poor
standstill
could not assess
Pericardial fluid absent
some
could not assess
US, ultrasound; LV, left ventricle; RV, right ventricle.
Impacted treatment decisions
65 (64) 9 (9) 11 (11) –
3 (3) 17 (17)
8 (8) 11 (11) 15 (15) 62 (61) 6 (6)
87 (85) 5 (5) 10 (10)
In 49 patients (88%) treatment decisions were impacted or supported based on ultrasound. In 32 patients (57%) ultrasound led to or supported the decision to terminate the resuscita- tive effort. In 21 patients (38%) it was indicated that at least once (in 29 of 102 examinations (28%)) ultrasound supported the continuation of resuscitation.
Of 102 ultrasound examinations, 62 (61%) impacted or supported management decisions. One examination may have led to multiple changes; 78 impacted decisions were recorded. The number of impacted decisions does not include 29 examinations where physicians re- ported continuation of resuscitation was influenced by ultrasound. This is not considered impacted treatment, but apparently echocardiography was perceived to have played a role in decision-making.
All reported decision changes are displayed in Table 8.4.