I saw this tweet from Salim during EEM a few weeks ago and it definitely caught my attention.
Upon further research (thanks Miesemer) I found some interesting data (FEEL Study) that shows 35% of the reported asystolic arrests had cardiac motion upon evaluation with POCUS.
The argument usually is “ what does it hurt?” The counter argument typically has to do with time off the chest.However if the monitor is pre-charged, the time off the chest is literally seconds and I don't believe this be an issue in regards to coronary perfusion pressures.
Swami discusses how they make sure they spend only five seconds getting their window during the pause.
A larger in-hospital study (REASON) had similar findings. REBEL EM did a great job breaking this study down. link .
I asked Swami to come on FOAMfrat and explain the science behind the idea of shocking asystole. We had a great discussion and I hope you enjoy!
Check out more content from Swami (@emswami)
Anand Swaminathan is an assistant clinical professor of Emergency Medicine at NYU/Bellevue in NYC. His main interests are in resident education, resuscitation and knowledge translation. Anand is an deputy editor for EM: RAP. He is a big believer in and contributor to the Free Open Access Medical Education (FOAM) movement. Anand is the creator and editor-in-chief of the Core EM project, which endeavors to bring great core content Emergency Medicine to any and all Emergency Providers via a multi-platform blog with blog posts, podcasts and vodcasts. He is also an associate editor for REBEL EM and REBELCast. Anand is a regular contributor to Life in the Fastlane, ER Cast and The Skeptics Guide to Emergency Medicine.
When not working, Anand enjoys long distance running and building Legos with his kids (Matt 10, Maya 7 and Luke 3).