Integration of Paramedic-led Echocardiography in Pulseless Electrical Activity (PEA) During Out-of-hospital Cardiac Arrest: An Education and Simulation Study.
type: CreativeWork
description: During out-of-hospital cardiac arrest, patients presenting in pulseless electrical activity (PEA) may receive inappropriate care if a manual pulse check determines pulselessness. This study created the Cardiac Arrest Focused Echocardiography (CAFE) exam incorporating a pre-imaging technique to reduce the time spent acquiring an ultrasound image. Paramedic participants were trained to use the CAFE exam and to record an 8 second image during the pulse check pause. The paramedic performing the CAFE exam is supernumerary to standard cardiac arrest proceedings and must not interrupt the delivery of cardiopulmonary resuscitation (CPR). Real-time ultrasound image interpretation during the CPR cycle determined the presence of a pericardial effusion, tamponade physiology, and heart function. Research Aim. To determine if paramedics can acquire an ultrasound image during the 10 second pulse check pause in simulated PEA cardiac arrest. Secondary aims focus on ultrasound image acquisition quality, interpretation, and retention of learned knowledge. Method. The study recruited 30 paramedics from Wellington, New Zealand. This study adhered to the reporting guidelines set by the International Network for Simulation-based Paediatric Innovation Research and Education (INSPIRE). Participants were divided into two equal groups and completed three trial phases between January to March 2022. Phase I involved an eLearning program covering ultrasound theory, ultrasound device orientation, echocardiogram views, PEA, cardiac arrest ultrasound, and cardiac arrest considerations for Māori. Phase II involved 4.5 hours of classroom theoretical and practical education, including competency-based assessments. The assessments included simulations testing hands-off time (HOT), pathological image interpretation, echocardiography (echo) skills and a knowledge test. The phase II assessments were replicated in phase III to assess knowledge and skill retention. Findings. The mean HOT was 9.6 seconds (SD…
abstract: During out-of-hospital cardiac arrest, patients presenting in pulseless electrical activity (PEA) may receive inappropriate care if a manual pulse check determines pulselessness. This study created the Cardiac Arrest Focused Echocardiography (CAFE) exam incorporating a pre-imaging technique to reduce the time spent acquiring an ultrasound image. Paramedic participants were trained to use the CAFE exam and to record an 8 second image during the pulse check pause. The paramedic performing the CAFE exam is supernumerary to standard cardiac arrest proceedings and must not interrupt the delivery of cardiopulmonary resuscitation (CPR). Real-time ultrasound image interpretation during the CPR cycle determined the presence of a pericardial effusion, tamponade physiology, and heart function. Research Aim. To determine if paramedics can acquire an ultrasound image during the 10 second pulse check pause in simulated PEA cardiac arrest. Secondary aims focus on ultrasound image acquisition quality, interpretation, and retention of learned knowledge. Method. The study recruited 30 paramedics from Wellington, New Zealand. This study adhered to the reporting guidelines set by the International Network for Simulation-based Paediatric Innovation Research and Education (INSPIRE). Participants were divided into two equal groups and completed three trial phases between January to March 2022. Phase I involved an eLearning program covering ultrasound theory, ultrasound device orientation, echocardiogram views, PEA, cardiac arrest ultrasound, and cardiac arrest considerations for Māori. Phase II involved 4.5 hours of classroom theoretical and practical education, including competency-based assessments. The assessments included simulations testing hands-off time (HOT), pathological image interpretation, echocardiography (echo) skills and a knowledge test. The phase II assessments were replicated in phase III to assess knowledge and skill retention. Findings. The mean HOT was 9.6 seconds (SD…
author: Latta, Hannah
date published: 2024
date modified: 2026-07-27T18:45:41Z
provider: AUT University
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: AUT University