ABSTRACT
Point-of-care ultrasound (POCUS) has been shown to be a valuable tool in the management of acutely ill patients in the prehospital setting. POCUS not only has utility from a diagnostic perspective but also has been shown to reduce the rate of complications from otherwise traditionally "blind" procedures, such as pericardiocentesis. This case report highlights the utility of POCUS in the prehospital setting to guide emergent pericardiocentesis to treat cardiac tamponade. The applicability of various approaches to ultrasound-guided pericardiocentesis is also discussed.
Subject(s)
Cardiac Tamponade , Emergency Medical Services , Pericardiocentesis , Point-of-Care Systems , Humans , Pericardiocentesis/methods , Emergency Medical Services/methods , Cardiac Tamponade/diagnostic imaging , Cardiac Tamponade/surgery , Cardiac Tamponade/therapy , Male , Ultrasonography, Interventional/methods , Ultrasonography/methods , Middle Aged , Pericardial Effusion/diagnostic imaging , Pericardial Effusion/surgery , Pericardial Effusion/therapyABSTRACT
Point-of-care ultrasound (POCUS) is a safe diagnostic tool that clinicians use to rapidly evaluate critically ill patients.1 POCUS has expanded into the prehospital setting and has been demonstrated to be accurate, feasible, and helpful in guiding clinical decision making.2-4 Additionally, the American College of Emergency Physicians recommends the use of echocardiography to evaluate for ventricular activity in the setting of cardiac arrest.5 There is minimal evidence regarding the use of POCUS to confirm mechanical capture in patients undergoing transcutaneous pacing. This case report highlights the use of POCUS in a patient with bradyasystolic cardiac arrest requiring transcutaneous pacing. Despite electrical capture, the patient had absent central pulses; however, POCUS demonstrated ventricular contractions, indicating mechanical capture. This suggests a role for POCUS for the evaluation of mechanical capture in patients undergoing cardiac pacing.