It is 5 step 40 seconds protocol for patients in cardiac arrest.
1. Ruling out pneumothorax
- A quick 2 second assesment can be done at anterior thorax or lower inflection point of blue point and look for lung sliding, B lines or A lines.
2.Looking for pulmonary embolism
- PE is ruléd out indirectly in this protocol by assessing femoral vein for DVT. It is based on the fact that almost half of the PE patients will have DVT and ruling out DVT makes PE unlikely.
3. Diagnosis of Hypovolemic Cardiac Arrest
- Look for fluid in the abdomen, lungs and IVC Collapsibility.
4. Ruling out Pericardial Tamponade
- Pericardial effusion can be ruled out by a subcostal approach.
5. Heart
- Look for
Asystole - a sign of poor prognosis
RV Dilatation - PE
Dancing heart -Pericardial Tamponade
LV Hypercontractility - Hypovolemia
Reference
- Lichtenstein D, Malbrain ML. Critical care ultrasound in cardiac arrest. Technological requirements for performing the SESAME-protocol--a holistic approach. Anaesthesiol Intensive Ther. 2015;47(5):471-81. doi: 10.5603/AIT.a2015.0072. Epub 2015 Nov 18. PMID: 26578398.
