Emergency Care, Sydney Adventist Hospital, Sydney, New South Wales, Australia.
Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Emerg Med Australas. 2019 Dec;31(6):1115-1118. doi: 10.1111/1742-6723.13374. Epub 2019 Aug 27.
Focused echocardiography may be a useful tool in cardiopulmonary resuscitation for prognostication, to identify certain reversible causes of cardiac arrest, and to guide further management and procedures. Nonetheless, many clinicians have reservations regarding its widespread adoption due to evidence that it leads to prolonged interruption of cardiac compressions. Furthermore, the lack of a clear protocol for the inclusion of focused echocardiography into the rhythm check can lead to confusion in teams not familiar with incorporating the modality, as well as safety concerns for the echosonographer during delivery of a shock. We propose the protocol COACHRED to guide the use of focused echocardiography during rhythm check in a safe and timely manner. This approach incorporates the best strategies identified to date that minimise interruptions to chest compressions. We demonstrate that, in a simulation environment, it is achievable to incorporate focused echocardiography into the rhythm check while keeping the interruption to chest compressions within the timeframe prescribed by international guidelines.
在心肺复苏中，聚焦超声心动图可能是一种有用的预后工具，可以识别某些导致心脏骤停的可逆性原因，并指导进一步的管理和操作。尽管如此，由于证据表明它会导致心脏按压的长时间中断，许多临床医生对其广泛采用持保留意见。此外，由于缺乏将聚焦超声心动图纳入节律检查的明确方案，不熟悉整合该方法的团队可能会感到困惑，并且在进行电击时，超声科医生的安全性也令人担忧。我们提出了 COACHRED 方案，以安全、及时的方式指导在节律检查期间使用聚焦超声心动图。这种方法结合了迄今为止确定的最佳策略，最大限度地减少了对胸外按压的干扰。我们证明，在模拟环境中，可以在不超过国际指南规定的时间限制的情况下，将聚焦超声心动图纳入节律检查。
