Lung Ultrasound as the First Step of Management of a Cardiac Arrest: The SESAME-Protocol
In cardiac arrest, the SESAME-protocol proposes to scan first the lung for two major targets: pneumothorax and clearance for fluid therapy. This information can be obtained in less than 5 s, i.e., a minimal hindrance in the course of resuscitation.
The SESAME-protocol then scans the lower femoral veins and the belly (first if trauma), for detecting pulmonary embolism or massive bleeding.
Then a pericardial tamponade is sought for.
Cardiac causes then follow, in position 5.
KeywordsPulmonary Embolism Cardiac Arrest Fluid Therapy Massive Pulmonary Embolism Lung Ultrasound
Pericardial tamponade. This video clip shows for the youngest a basic pericardial tamponade from a subcostal window. The heart is recognized, beating, and surrounded by an external line: pericardial effusion is diagnosed. This effusion is substantial (20 mm at the inferior aspect). The right cardiac cavities are collapsed, indicating here a tamponade (MOV 2502 kb)
Asystole. Nothing much to be written here. A few seconds were necessary for recording this loop. This is a fresh cardiac arrest, maybe the visible floating sludge is a sign of recent arrest (good neurological recovery after ROSC in this hypoxic arrest) (MOV 2502 kb)
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