Identification of causes of PEA arrest by FOCUS with zero or minimal interruption in cardiopulmonary resuscitation improves outcomes by decreasing time to treatment and to return of spontaneous circulation. FOCUS is only recommended in PEA and asystolic rhythms and should not delay lifesaving treatment of ventricular arrhythmias. These patients should be stabilized, and a comprehensive echocardiogram, looking for potential specific structural abnormalities such as hypertrophic cardiomyopathy or RV dysplasia, can be performed at a later point.
CONCLUSION The use of FOCUS requires knowledge of the strengths and limitations of this imaging modality. There are limitations of the FOCUS exam secondary to both the nature of the exam and the training of the individual interpreting the study. Valvular heart disease, diastolic function, and segmental wall motion analysis are examples of cardiac abnormalities that should eventually be assessed by comprehensive
Focused echocardiography is used only to answer defined clinical questions and not to detect all possible cardiac pathology
echocardiography. Abnormal findings on FOCUS should be referred for comprehensive echocardiography, other testing, or consultation when the situation allows for this to be done safely. However, FOCUS can identify pathologic processes that can guide resuscitative interventions and be lifesaving. In the end, patient care will be assisted by cooperation between these two professional groups that are both dedicated to the rapid and accurate diagnosis and treatment of patients using this valuable technology. ■
ID
REFERENCES References available on request (
magazine@informa.com)
FIG 8: Type A aortic dissection diagram. Suprasternal ultrasound view of the aortic arch. The imaging plane crosses the intimal flap in two locations (arrows).
FIG 7 & 8 7
8
FIG 7: M-MODE
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