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Predictive utility of cardiac ultrasound in traumatic cardiac arrest in a combat casualty
  1. Rex Kinnear-Mellor1,
  2. K Newton2,
  3. T Woolley3 and
  4. R Rickard4
    1. 1Department of Anaesthetics, Queens Medical Centre, Nottingham, UK
    2. 2University Hospital of South Manchester, Manchester, UK
    3. 3Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, Birmingham, UK
    4. 4Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
    1. Correspondence to Surg Lt Cdr Rex Kinnear-Mellor, Department of Anaesthetics, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, UK; rgmellor{at}doctors.org.uk

    Abstract

    We report a case of traumatic cardiac arrest in a combat casualty who was resuscitated to return of spontaneous circulation despite asystole and no visible cardiac activity on initial ultrasound examination. This return of spontaneous circulation suggests that survival may be possible in traumatic cardiac arrest due to exsanguination, even when there is no demonstrable cardiac activity on ultrasound. Cardiac ultrasonography was performed for 10 s only. We suggest that cardiac ultrasonography should be performed for a minimum of 1 min during volume resuscitation. If absence of cardiac activity is confirmed once the heart is full, and there are no other signs of life (including pupillary reaction), then termination of resuscitation should be considered.

    • ULTRASONOGRAPHY
    • ACCIDENT & EMERGENCY MEDICINE
    • Received September 7, 2014.
    • Revision received February 3, 2015.
    • Accepted February 4, 2015.

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    • Received September 7, 2014.
    • Revision received February 3, 2015.
    • Accepted February 4, 2015.
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