Contributor: Aaron Lessen, MD
Educational Pearls:
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Point-of-care ultrasound (POCUS) is used to assess cardiac activity during cardiac arrest and can identify potential reversible causes such as pericardial tamponade
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Ultrasound could be beneficial in another way during cardiac arrest as well: pulse checks
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Manual palpation for detecting pulses is imperfect, with false positives and negatives
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Doppler ultrasound can be used as an adjunct or replacement to manual palpation for improved accuracy
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Options for Doppler ultrasound of carotid or femoral pulses during cardiac arrest:
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Visualize arterial pulsation
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Use color doppler
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Numerically quantify the flow and correlate this to a BP reading – slightly more complex
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Doppler ultrasound is much faster than manual palpation for pulse check
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Can provide information almost instantaneously without waiting the full 10 seconds for a manual pulse check
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The main priority during cardiac arrest resuscitation is to maintain quality compressions
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If pulses are unable to be obtained through Doppler within the 10-second window, resume compressions and try again during the next pulse check
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References
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Cohen AL, Li T, Becker LB, Owens C, Singh N, Gold A, Nelson MJ, Jafari D, Haddad G, Nello AV, Rolston DM; Northwell Health Biostatistics Unit. Femoral artery Doppler ultrasound is more accurate than manual palpation for pulse detection in cardiac arrest. Resuscitation. 2022 Apr;173:156-165. doi: 10.1016/j.resuscitation.2022.01.030. Epub 2022 Feb 4. PMID: 35131404.
