Clinical trial NCT04790396: Carotid Ultrasound Under Pulsed-wave Doppler Mode to Check the Pulse in Cardiopulmonary Arrest Patients.
Official title: Carotid Ultrasound Under Pulsed-wave Doppler Mode to Check the Pulse in Cardiopulmonary Arrest Patients.
Study type: OBSERVATIONAL
Overall status: ACTIVE_NOT_RECRUITING
Conditions: Cardiac Arrest
Lead sponsor: National Taiwan University Hospital
Sponsor class: OTHER
First posted: 2021-03-10
Enrollment: 50
Sex: ALL
Minimum age (years): 20
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: CASE_ONLY
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: any patient presenting at ER with cardiac arrest older than 20 years-old, including trauma or non-trauma cardiac arrest, in-hospital or out-of-hospital cardiac arrest

Brief summary: It's crucial to determine whether a pulse is present or not in patient with cardiac arrest. But more and more studies have shown that manual palpation is unreliable for detecting pulse 1-4. Failure to detect pulselessness may cause delay of chest compression and directly affect the patient's outcome. Likewise, failure to rapidly detect return of spontaneous circulation may cause prolonged chest compression and increase associated injury during resuscitation.

More and more studies have demonstrated that echo guided pulse detection is feasible 5-7. The aim of our study is to check carotid pulse via ultrasound. This is a prospective study and the patient selection is in-hospital or out of hospital cardiac arrest. A curvilinear ultrasonography transducer is used and placed transversely on either right/left carotid artery under pulsed-wave doppler mode to check whether the pulse is present or not. The result of ultrasonography will be compared with manual palpation and to determine the accuracy and effectiveness of clinical usage.


Eligibility criteria: Inclusion Criteria:

* any patient presenting at ER with cardiac arrest older than 20 years-old

Exclusion Criteria:

* younger than 20 years-old
* patient who is pregnant

Primary outcomes:
measure: Carotid ultrasound under pulsed-wave doppler compared with manual palpation
timeFrame: 5 seconds during pulse check period of resuscitation
measure: Carotid ultrasound under pulsed-wave doppler compared with manual palpation
timeFrame: 5 seconds during pulse check period of resuscitation
Secondary outcomes:
Other outcomes:
Locations:
city: Taipei
country: Taiwan
facility: National Taiwan University Hospital
Study officials:
References:
citation: Bahr J, Klingler H, Panzer W, Rode H, Kettler D. Skills of lay people in checking the carotid pulse. Resuscitation. 1997 Aug;35(1):23-6. doi: 10.1016/s0300-9572(96)01092-1.
citation: Eberle B, Dick WF, Schneider T, Wisser G, Doetsch S, Tzanova I. Checking the carotid pulse check: diagnostic accuracy of first responders in patients with and without a pulse. Resuscitation. 1996 Dec;33(2):107-16. doi: 10.1016/s0300-9572(96)01016-7.
citation: Moule P. Checking the carotid pulse: diagnostic accuracy in students of the healthcare professions. Resuscitation. 2000 May;44(3):195-201. doi: 10.1016/s0300-9572(00)00139-8.
citation: Liberman M, Lavoie A, Mulder D, Sampalis J. Cardiopulmonary resuscitation: errors made by pre-hospital emergency medical personnel. Resuscitation. 1999 Sep;42(1):47-55. doi: 10.1016/s0300-9572(99)00082-9.
citation: Badra K, Coutin A, Simard R, Pinto R, Lee JS, Chenkin J. The POCUS pulse check: A randomized controlled crossover study comparing pulse detection by palpation versus by point-of-care ultrasound. Resuscitation. 2019 Jun;139:17-23. doi: 10.1016/j.resuscitation.2019.03.009. Epub 2019 Mar 20.
citation: Simard RD, Unger AG, Betz M, Wu A, Chenkin J. The POCUS Pulse Check: A Case Series on a Novel Method for Determining the Presence of a Pulse Using Point-of-Care Ultrasound. J Emerg Med. 2019 Jun;56(6):674-679. doi: 10.1016/j.jemermed.2019.02.013. Epub 2019 Apr 16.
citation: Germanoska B, Coady M, Ng S, Fermanis G, Miller M. The reliability of carotid ultrasound in determining the return of pulsatile flow: A pilot study. Ultrasound. 2018 May;26(2):118-126. doi: 10.1177/1742271X17753467. Epub 2018 Jan 29.