Lung Ultrasound as the First Step of Management of a Cardiac Arrest: The SESAME-Protocol

  • Daniel A. Lichtenstein


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.


Pulmonary Embolism Cardiac Arrest Fluid Therapy Massive Pulmonary Embolism Lung Ultrasound 
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Supplementary material

Video 31.1

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)

Video 31.2

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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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Daniel A. Lichtenstein
    • 1
  1. 1.Hôpital Ambroise Paré Service de Réanimation MédicaleBoulogne (Paris-West University)France

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