Pediatric Cardiac Standstill Assessment by Pediatric Emergency Medicine Physicians With Point-of-Care Ultrasound: A...

The objective of this study was to determine the ability of pediatric emergency medicine (PEM) physicians to use cardiac POCUS for the evaluation of cardiac standstill by obtaining cardiac POCUS images on healthy model pediatric patients in ≤10 seconds before and after a brief training video and then interpreting prerecorded cardiac POCUS images for cardiac standstill versus organized cardiac activity as quickly as possible.

This was a single-center, prospective, simulation-based study. During simulated pediatric cardiac arrest scenarios, PEM physicians performed cardiac POCUS, reviewed a training video, and then reperformed cardiac POCUS. Subjects then interpreted 12 prerecorded cardiac POCUS video images as cardiac activity or standstill. The time to perform cardiac POCUS and to interpret images was recorded.

Twenty PEM physicians participated. There was no change in median time, 10 seconds, to obtain cardiac POCUS images before and after the training video ( P =0.44). When data were dichotomized by ≤10 or >10 seconds, the odds of obtaining the image in ≤10 seconds were 3.5 times higher after viewing the video (95% CI=0.7, 34.5). When interpreting cardiac images, 40% (n=8) interpreted all of the images correctly; however, only 10% (n=2) did so in ≤10 seconds.

The majority of PEM physicians can obtain cardiac POCUS images for the evaluation of cardiac standstill in ≤10 seconds. The ability to interpret cardiac POCUS images for cardiac activity or standstill in ≤10 seconds is variable; further research is needed to determine whether additional training could improve overall precision and timeliness.