Domagoj Damjanovic, Tobias Schröder, Raoul Breitkreutz
Resuscitation ultrasound is a subgroup of point-of-care ultrasound (PoCUS) procedures to improve resuscitation efforts. It can lead to interventions and mainly differs from expert transthoracic echocardiography or laboratory ultrasound of routine diagnostics: Resuscitation ultrasound should be simple, trainable by a broad number of doctors handling acute medical problems. Thus, rather than imaging experts, resuscitation experts are required.
Clinical scientists start research in this field often with an acronym naming a “protocol”. Such protocols introduce novel PoCUS approaches and contain a limited number of sonograms to be obtained in a specific order with the aim to understand the actual physiological state of a patient . Resuscitation related protocols are e.g. TRUE for airway management, FAST/E-FAST in trauma, LUS for lung ultrasound, FEEL, SHoC or RUSH in shock. Early protocols (e.g. FATE) describe static views and were not developed for ALS, originally. Unfortunately acronyms for such protocols are increasing in numbers and rigorous scientific validation is scarce, except few with feasibility data or small sample size. Tests within specific clinical scenarios, robust data on improvement in training or clinical outcomes are still lacking (e.g. for CAUSE, RUSH, FATE, BLEEP, CLUE or EGLS).
However dynamic PoCUS protocols more include procedural aspects and start with a clinical question, describe a step by step approach of obtaining sonograms within different clinical processes, suggest the integration within a clinical procedure (e.g. ALS) and end with a clinical answer. Dynamic protocols are e.g. airway ultrasound exam , sweep of subxiphoid four chamber view with inferior vena cava (IVC), short axis, which would be mandatory in CPR [, , ]. Lung ultrasound limited to pneumothorax diagnostics, which would be of utmost interest, has been included into the European Resuscitation Council (ERC) guidelines, but has not been tested in CPR . Nevertheless, ERC 2015 guidelines contain several resuscitation ultrasound methods