2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6eb,Point-of-care ultrasound (POCUS) is widely used in emergency departments (ED) and has potential value during cardiac arrest for identifying reversible causes (e.g., pericardial effusion, pneumothorax and pulmonary embolism) and guiding resuscitation. However, its role remains inconsistently applied. This study describes the use of POCUS during ED cardiac arrests, including frequency, association with rhythm type and impact on interventions. A retrospective review was conducted across three Sydney EDs from November 2020 to October 2023 (3 years). Patients were included if they received CPR in the ED; those with resuscitation ceased on arrival under an advanced directive were excluded. Data collected included demographics, presenting rhythm, POCUS use, interventions prompted by POCUS findings and outcomes. Of 528 cardiac arrests, 257 met inclusion criteria. Median age was 66 years (IQR:54-80), with 67% male. Nonshockable rhythms were present in 159 (62%). POCUS was performed in 196 (76%): 76/98 (78%) with shockable rhythms and 119/159 (75%) with nonshockable rhythms. A reversible cause was identified in six: four pericardial effusions (treated with pericardiocentesis) and two suspected pulmonary emboli (treated with thrombolysis). No patient achieved return of spontaneous circulation following intervention. Overall survival to discharge was 12/257 (5%): 7/98 (7%) in shockable rhythms and 5/159 (3%) in nonshockable rhythms. POCUS was commonly used during cardiac arrest and identified reversible pathology in a small number; however, these findings did not alter outcomes. While POCUS can assist in identifying reversible causes, its use must not disrupt high-quality chest compressions, which remain the cornerstone of cardiac arrest management.31:T970,ABSTRACT Background Point‐of‐care ultrasound (POCUS) is widely used in emergency departments (ED) and has potential value during cardiac arrest for identifying reversible causes (e.g., pericardial effusion, pneumothorax and pulmonary embolism) and guiding resuscitation. However, its role remains inconsistently applied. This study describes the use of POCUS during ED cardiac arrests, including frequency, association with rhythm type and impact on interventions. Methods A retrospective review was conducted across three Sydney EDs from November 2020 to October 2023 (3 years). Patients were included if they received CPR in the ED; those with resuscitation ceased on arrival under an advanced directive were excluded. Data collected included demographics, presenting rhythm, POCUS use, interventions prompted by POCUS findings and outcomes. Results Of 528 cardiac arrests, 257 met inclusion criteria. Median age was 66 years (IQR:54–80), with 67% male. Nonshockable rhythms were present in 159 (62%). POCUS was performed in 196 (76%): 76/98 (78%) with shockable rhythms and 119/159 (75%) with nonshockable rhythms. A reversible cause was identified in six: four pericardial effusions (treated with pericardiocentesis) and two suspected pulmonary emboli (treated with thrombolysis). No patient achieved return of spontaneous circulation following intervention. Overall survival to discharge was 12/257 (5%): 7/98 (7%) in shockable rhythms and 5/159 (3%) in nonshockable rhythms. Conclusions POCUS was commonly used during cardiac arrest and identified reversible pathology in a small number; however, these findings did not alter outcomes. While POCUS can assist in identifying reversible causes, its use must not disrupt high‐quality chest compressions, which remain the cornerstone of cardiac arrest management. 32:T715,Point-of-care cardiac ultrasonography (POCUS) is commonly used for pulse determination in cardiac arrest. It is unknown whether pulse determination using carotid artery POCUS can be obtained more quickly and successfully than with the subxiphoid view in the prehospital environment. Our objective was to compare carotid and subxiphoid pulse determination by paramedics during out-of-hospital cardiac arrest (OHCA). We hypothesize that prehospital carotid POCUS views may be obtained more quickly and successfully than the subxiphoid approach. We conducted an observational study comparing carotid and subxiphoid POCUS for pulse determination during OHCA among a suburban, third-service emergency medical services (EMS) agency (90,000 activations per year). Videos were recorded throughout each cardiopulmonary resuscitation (CPR) pause, and paramedics alternated carotid and subxiphoid views on the same patient. Videos were evaluated for view adequacy, interrater reliability and agreement assessed. Differences in view adequacy and compression pause duration between carotid and subxiphoid POCUS approaches were analyzed. McNemar's test was used to compare the proportion of adequate views and compression pauses. A total of 248 POCUS recordings from 107 patients were analyzed. Image quality was assessed for adequacy, demonstrating high interrater reliability (kappa = 0.85) and 93 % agreement. Overall, 73 % (n = 195) had pause lengths <10 s, and 62 % (n = 153) had an adequate view. Compression pauses <10 s, and adequate views were achieved more frequently using carotid than subxiphoid POCUS (83 % vs. 39 % and 83 % vs. 63 %, respectively). Paramedic-obtained carotid POCUS demonstrated a significant increase in view adequacy and fewer extended CPR pauses, as compared to subxiphoid views.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Point-Of-Care Ultrasound: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Point-Of-Care Ultrasound (modality). Clinician-written summaries and actionable practice insights. 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Median age was 66 years (IQR:54-80), with 67% male. Nonshockable rhythms were present in 159 (62%). POCUS was performed in 196 (76%): 76/98 (78%) with shockable rhythms and 119/159 (75%) with nonshockable rhythms. A reversible cause was identified in six: four pericardial effusions (treated with pericardiocentesis) and two suspected pulmonary emboli (treated with thrombolysis). No patient achieved return of spontaneous circulation following intervention. Overall survival to discharge was 12/257 (5%): 7/98 (7%) in shockable rhythms and 5/159 (3%) in nonshockable rhythms.","abstract":"$30","keywords":["cardiac arrest","intervention","resuscitation","ultrasound"],"pubmed_id":"41496400","conclusions":"","publication_date":"2026-01-07T00:00:00"},"crossref":{"DOI":"10.1111/1742-6723.70209","URL":"https://doi.org/10.1111/1742-6723.70209","ISSN":["1742-6731","1742-6723"],"link":[{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/1742-6723.70209","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"1","score":1,"title":["Use of Point‐of‐Care Ultrasound During Cardiac Arrest in the Emergency Department: A Multicentre Retrospective Study"],"author":[{"given":"Geraldine","family":"Hancock","sequence":"first","affiliation":[{"name":"Emergency Department Prince of Wales Hospital Randwick New South Wales Australia"}]},{"given":"Eugenie","family":"Batterby","sequence":"additional","affiliation":[{"name":"Emergency Department The Sutherland Hospital Caringbah New South Wales Australia"}]},{"given":"Elliot","family":"Dovers","sequence":"additional","affiliation":[{"name":"Stats Central University of NSW Sydney New South Wales Australia"}]},{"given":"Chris","family":"Harrington","sequence":"additional","affiliation":[{"name":"Emergency Department Prince of Wales Hospital Randwick New South Wales Australia"}]},{"given":"Steve","family":"Korbel","sequence":"additional","affiliation":[{"name":"Emergency Department St. George Hospital Kogarah New South Wales Australia"}]},{"given":"Adam","family":"Hudson","sequence":"additional","affiliation":[{"name":"Emergency Department Prince of Wales Hospital Randwick New South Wales Australia"}]},{"given":"Angela L.","family":"Chiew","sequence":"additional","affiliation":[{"name":"Emergency Department Prince of Wales Hospital Randwick New South Wales Australia"},{"name":"Prince of Wales Clinical School UNSW Medicine Sydney New South Wales Australia"}]}],"funder":[{"id":[{"id":"10.13039/501100000925","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/501100000925","name":"National Health and Medical Research Council","award":["AC: Emerging Leadership 1 (ID 2016380)"],"award-info":[{"award-number":["AC: Emerging Leadership 1 (ID 2016380)"]}],"doi-asserted-by":"publisher"}],"issued":{"date-parts":[[2026,1,6]]},"member":"311","prefix":"10.1111","source":"Crossref","volume":"38","archive":["Portico"],"created":{"date-time":"2026-01-07T06:11:47Z","timestamp":1767766307000,"date-parts":[[2026,1,7]]},"indexed":{"date-time":"2026-01-07T06:15:50Z","timestamp":1767766550149,"date-parts":[[2026,1,7]]},"license":[{"URL":"http://onlinelibrary.wiley.com/termsAndConditions#vor","start":{"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000,"date-parts":[[2026,1,6]]},"delay-in-days":0,"content-version":"vor"}],"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://onlinelibrary.wiley.com/doi/10.1111/1742-6723.70209"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","order":0,"value":"2025-07-14"},{"name":"accepted","group":{"name":"publication_history","label":"Publication History"},"label":"Accepted","order":2,"value":"2025-12-23"},{"name":"published","group":{"name":"publication_history","label":"Publication History"},"label":"Published","order":3,"value":"2026-01-06"}],"deposited":{"date-time":"2026-01-07T06:11:58Z","timestamp":1767766318000,"date-parts":[[2026,1,7]]},"issn-type":[{"type":"print","value":"1742-6731"},{"type":"electronic","value":"1742-6723"}],"published":{"date-parts":[[2026,1,6]]},"publisher":"Wiley","reference":[{"DOI":"10.1016/j.resuscitation.2022.01.011","key":"e_1_2_9_2_1","year":"2022","issue":null,"author":"Bray J.","volume":"172","first-page":"74","unstructured":null,"article-title":"The Epidemiology of Out‐Of‐Hospital Cardiac Arrest in Australia and New Zealand: A Binational Report From the Australasian Resuscitation Outcomes Consortium (Aus‐ROC)","journal-title":"Resuscitation","doi-asserted-by":"crossref"},{"DOI":"10.1097/ALN.0000000000003811","key":"e_1_2_9_3_1","year":"2021","issue":"3","author":"Paul J. 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Reversible causes were found in 6 (4 pericardial effusions treated with pericardiocentesis; 2 suspected pulmonary emboli treated with thrombolysis); no patient achieved return of spontaneous circulation after these interventions. Survival to discharge was 12/257 (5%): 7/98 (7%) shockable vs 5/159 (3%) nonshockable.","limitations":"Retrospective, single-region sample from three Sydney EDs limits generalizability. Inclusion was limited to ED arrests receiving CPR and excluded patients with resuscitation ceased on arrival under an advanced directive; very few POCUS-identified reversible causes (n=6) restrict inferences about outcome impact.","practice_takeaway":"POCUS was commonly used but rarely uncovered a reversible cause, and POCUS-guided interventions did not produce ROSC in this cohort. If used, ensure it does not interrupt high-quality chest compressions, which remain the priority."}},{"doi":"10.1016/j.resuscitation.2025.110953","pmid":"41478585","title":"Delays in chest compressions during out-of-hospital cardiac arrest: carotid versus subxiphoid point of care ultrasound","journal_title":"Resuscitation","journal_issn":"0300-9572","published_at":"2026-01-02T00:00:00.000Z","url":"https://doi.org/10.1016/j.resuscitation.2025.110953","source_score":9,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-13","doi":"10.1016/j.resuscitation.2025.110953","days":"14","issn":"0300-9572","rank":"3","field":"Clinical Medicine","score":"9","category":"Emergency Medicine","categories":["Emergency Medicine"],"_categories":["Emergency Medicine"]},"pubmed":{"doi":"10.1016/j.resuscitation.2025.110953","title":"Delays in chest compressions during out-of-hospital cardiac arrest: carotid versus subxiphoid point of care ultrasound.","journal":"Resuscitation","methods":"","results":"A total of 248 POCUS recordings from 107 patients were analyzed. Image quality was assessed for adequacy, demonstrating high interrater reliability (kappa = 0.85) and 93 % agreement. Overall, 73 % (n = 195) had pause lengths <10 s, and 62 % (n = 153) had an adequate view. Compression pauses <10 s, and adequate views were achieved more frequently using carotid than subxiphoid POCUS (83 % vs. 39 % and 83 % vs. 63 %, respectively).","abstract":"$32","keywords":["Cardiac arrest","Emergency medical services","Paramedics","Point-of-care ultrasound","Resuscitation"],"pubmed_id":"41478585","conclusions":"Paramedic-obtained carotid POCUS demonstrated a significant increase in view adequacy and fewer extended CPR pauses, as compared to subxiphoid views.","publication_date":"2026-01-02T00:00:00"},"crossref":{"DOI":"10.1016/j.resuscitation.2025.110953","URL":"https://doi.org/10.1016/j.resuscitation.2025.110953","ISSN":["0300-9572"],"link":[{"URL":"https://api.elsevier.com/content/article/PII:S0300957225009657?httpAccept=text/xml","content-type":"text/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https://api.elsevier.com/content/article/PII:S0300957225009657?httpAccept=text/plain","content-type":"text/plain","content-version":"vor","intended-application":"text-mining"}],"page":"110953","type":"journal-article","issue":null,"score":1,"title":["Delays in chest compressions during out-of-hospital cardiac arrest: carotid versus subxiphoid point of care ultrasound"],"author":[{"given":"Casey","family":"Patrick","sequence":"first","affiliation":[]},{"given":"Kevin","family":"Crocker","sequence":"additional","affiliation":[]},{"given":"Brad","family":"Ward","sequence":"additional","affiliation":[]},{"given":"James","family":"Seek","sequence":"additional","affiliation":[]},{"given":"Nick","family":"Smith","sequence":"additional","affiliation":[]},{"given":"Michael","family":"Wells","sequence":"additional","affiliation":[]},{"given":"Christopher B.","family":"Gage","sequence":"additional","affiliation":[]},{"given":"Jonathan R.","family":"Powell","sequence":"additional","affiliation":[]},{"given":"Ashish R.","family":"Panchal","sequence":"additional","affiliation":[]},{"given":"Robert","family":"Dickson","sequence":"additional","affiliation":[]}],"funder":[{"id":[{"id":"10.13039/100024377","id-type":"DOI","asserted-by":"publisher"}],"DOI":"10.13039/100024377","name":"Montgomery County Government","doi-asserted-by":"publisher"}],"issued":{"date-parts":[[2026,2]]},"member":"78","prefix":"10.1016","source":"Crossref","volume":"219","created":{"date-time":"2025-12-30T15:48:55Z","timestamp":1767109735000,"date-parts":[[2025,12,30]]},"indexed":{"date-time":"2026-01-18T15:45:18Z","timestamp":1768751118196,"date-parts":[[2026,1,18]]},"license":[{"URL":"https://www.elsevier.com/tdm/userlicense/1.0/","start":{"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000,"date-parts":[[2026,2,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://www.elsevier.com/legal/tdmrep-license","start":{"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000,"date-parts":[[2026,2,1]]},"delay-in-days":0,"content-version":"tdm"},{"URL":"https://doi.org/10.15223/policy-017","start":{"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000,"date-parts":[[2026,2,1]]},"delay-in-days":0,"content-version":"stm-asf"},{"URL":"https://doi.org/10.15223/policy-037","start":{"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000,"date-parts":[[2026,2,1]]},"delay-in-days":0,"content-version":"stm-asf"},{"URL":"https://doi.org/10.15223/policy-012","start":{"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000,"date-parts":[[2026,2,1]]},"delay-in-days":0,"content-version":"stm-asf"},{"URL":"https://doi.org/10.15223/policy-029","start":{"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000,"date-parts":[[2026,2,1]]},"delay-in-days":0,"content-version":"stm-asf"},{"URL":"https://doi.org/10.15223/policy-004","start":{"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000,"date-parts":[[2026,2,1]]},"delay-in-days":0,"content-version":"stm-asf"}],"subject":[],"abstract":null,"language":"en","relation":{},"resource":{"primary":{"URL":"https://linkinghub.elsevier.com/retrieve/pii/S0300957225009657"}},"subtitle":[],"assertion":[{"name":"publisher","label":"This article is maintained by","value":"Elsevier"},{"name":"articletitle","label":"Article Title","value":"Delays in chest compressions during out-of-hospital cardiac arrest: carotid versus subxiphoid point of care ultrasound"},{"name":"journaltitle","label":"Journal Title","value":"Resuscitation"},{"name":"articlelink","label":"CrossRef DOI link to publisher maintained version","value":"https://doi.org/10.1016/j.resuscitation.2025.110953"},{"name":"content_type","label":"Content Type","value":"article"},{"name":"copyright","label":"Copyright","value":"© 2025 Elsevier B.V. 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Study","value_numeric":null},{"paper_doi":"10.1016/j.resuscitation.2025.110953","tag_type":"warning","value":"Design classification is approximate; prospective versus retrospective timing is not stated.","value_numeric":null},{"paper_doi":"10.1016/j.resuscitation.2025.110953","tag_type":"warning","value":"Only abstract-level details were available; study timeframe not reported.","value_numeric":null},{"paper_doi":"10.1016/j.resuscitation.2025.110953","tag_type":"warning","value":"Unit of analysis was recordings (n=248) from fewer patients (n=107), which may affect generalizability.","value_numeric":null}],"summaries":{"what_studied":"An observational comparison of carotid versus subxiphoid point-of-care ultrasound (POCUS) for pulse determination during out-of-hospital cardiac arrest by paramedics in a suburban EMS agency, with alternating views on the same patients and video review of CPR pauses (248 recordings from 107 patients).","key_result":"Compression pauses <10 s occurred more often with carotid than subxiphoid POCUS (83% vs 39%), and adequate views were more frequent (83% vs 63%). Overall, 73% (195/248) of recordings had pauses <10 s and 62% (153/248) had adequate views; image adequacy assessment showed high interrater reliability (kappa 0.85; 93% agreement).","limitations":"Single EMS agency limits generalizability; outcomes were analyzed per POCUS recording rather than strictly per patient (248 recordings from 107 patients). Study design was observational without randomization, and the timeframe was not reported.","practice_takeaway":"During OHCA in this EMS setting, carotid POCUS more often achieved adequate images and kept compression pauses under 10 seconds compared with the subxiphoid view. When using POCUS for pulse determination, favoring a carotid approach may help minimize CPR interruptions."}}],"initialOffset":2,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Point-Of-Care Ultrasound"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Point-Of-Care Ultrasound"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Point-Of-Care Ultrasound"}}}]]

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