Diagnosis of acute pulmonary embolism by point-of-care ultrasound under continuous cardiopulmonary resuscitation: case series
Abstract
Introduction and importance Acute pulmonary embolism, as one of the most common and dangerous diseases, sometimes can develop into cardiac arrest before receiving Computed Tomography Angiography (CTA) or other confirmatory workup. The success rate with merely Cardiopulmonary resuscitation (CPR) is extremely low, which raises the question whether it is appropriate to make medical decisions and treat patients empirically with systemic thrombolytic therapy based on point-of-care ultrasound. Case presentation This case series reported three cases in which patients presented with cardiac arrest in the emergency department, given the cases were too emergent for CTA, pulmonary embolism was diagnosed based on point-of-care ultrasound given the emergency of the condition, the patient was given systemic thrombolytic therapy with continuous CPR, and achieved Return of Spontaneous Circulation (ROSC). Clinical discussion These cases discuss the importance of bedside ultrasound in the rapid identification of acute pulmonary embolism and the importance of intravenous thrombolysis in the context of continuous cardiopulmonary resuscitation. Conclusion Point of care ultrasound plays a crucial role in rapidly identifying acute pulmonary embolism in the emergency department. Systematic therapy with continuous CPR is an effective management for patients with cardiac arrest secondary to acute pulmonary embolism.
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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