Page 179 - Ultrasonography in Prehospital and Emergency Medicine - Rein Ketelaars

Prehospital echocardiography during resuscitation impacts treatment in a physician-staffed HEMS 177
Table 8.4 Impact of ultrasound on treatment decisions
Change in decision
US examinations n (%)
Patients n (%)
Terminate resuscitation
More intravenous fluid administration Less intravenous fluid administration Adjust adrenaline dosage
Start dobutamine (inotropic drugs) Start phenylephrine (vasopressors) Administer heparine
Pericardiocentesis
Thoracostomy
Insert gastric tube
Transport to different hospital
Provide ED with additional information Other(a)
Continue resuscitation(b)
33 (32) 11 (11) 1 (1) 4 (4) 2 (2) –
2 (2) –
4 (4) 3 (3) 3 (3) 4 (4) 11 (11) 29 (28)
32 (57) 7 (13) 1 (2) 4 (7) 2 (4) –
2 (4) –
4 (7) 3 (5) 3 (5) 4 (7) 10 (18) 21 (38)
US, ultrasound; ED, emergency department.
Note: multiple changes can be associated with one examination or one patient.
a. Re-intubation because of absent bilateral lung sliding; withholding inotropic drugs; confirmation of tube position; increase noradrenaline dosage; increase cardiac pacing power output; not performing thoracostomies; stop cardiopulmonary resuscitation (ultrasound ROSC).
b. Continuation of resuscitation was reported as a decision after echocardiography, but not considered to be a change in treatment decisions.
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