Use of point-of-care ultrasound during cardiac arrest in the intensive care unit: A cross-sectional survey

David A West; Caroline Killick; Daryl Jones; POCUS-CA Collaborators

doi:10.1016/j.aucc.2024.04.003

Use of point-of-care ultrasound during cardiac arrest in the intensive care unit: A cross-sectional survey

Aust Crit Care. 2025 Jan;38(1):101058. doi: 10.1016/j.aucc.2024.04.003. Epub 2024 May 25.

Authors

David A West¹, Caroline Killick², Daryl Jones³; POCUS-CA Collaborators

Collaborators

POCUS-CA Collaborators:
Li Tan⁴, Cameron Knott⁵, David Brewster⁶, Philippe Le Fevre⁷, Ravindranath Tiruvoipati⁸, Matt Maiden⁹, Wissam Al-Bassam¹⁰, Tom Rechnitzer¹¹, Tim Haydon¹², K J Farley¹³

Affiliations

¹ Intensive Care Unit, Monash Hospital, Clayton, VIC, Australia. Electronic address: davidwest@posteo.net.
² Intensive Care Unit, Monash Hospital, Clayton, VIC, Australia; Department of Paediatrics, Monash University, VIC, Australia.
³ Intensive Care Unit, Austin Hospital, Heidelberg, VIC, Australia; Department of Surgery and Department of Intensive Care, University of Melbourne, Parkville, VIC, Australia; Department of Epidemiology and Preventive Medicine, Monash University, VIC, Australia.
⁴ Alfred Hospital, Australia.
⁵ Bendigo Hospital, Australia.
⁶ Cabrini Hospital, Australia.
⁷ Eastern Health, Australia.
⁸ Frankston Hospital, Australia.
⁹ Geelong Hospital, Australia.
¹⁰ Monash Health, Australia.
¹¹ Royal Melbourne Hospital, Australia.
¹² St Vincent's Hospital Melbourne, Australia.
¹³ Western Health, Australia.

PMID: 38797583
DOI: 10.1016/j.aucc.2024.04.003

Abstract

Background: There is growing interest in the use of point-of-care ultrasound during cardiac arrest, but few studies document its use in the intensive care unit.

Objective: We hypothesised this may reflect a low prevalence of use of point-of-care ultrasound during cardiac arrest or negative attitudes towards its use. We aimed to determine the self-reported prevalence, attitudes towards, and barriers to use of point-of-care ultrasound during cardiac arrest in the intensive care unit.

Methods: We conducted a web-based survey over 3 months (08/08/2022-06/11/2022), of intensive care unit consultants and registrars in Victoria, Australia. Descriptive and mixed-methods analyses of Likert-type and free-text answers were performed.

Results: The response rate was 91/398 (22.8%), split evenly between consultants and registrars. There was a broad range of clinical and ultrasound experience. Only 22.4% (22/91) of respondents reported using point-of-care ultrasound 75-100% of the time during their management of cardiac arrest. Respondents rated the value they place in point-of-care ultrasound during cardiac arrest 3 (interquartile range: 3-4) and that of a "skilled operator" 4 ((interquartile range; 4-5) on a 5-point scale. Free-text analysis suggested exclusion of "tamponade" (40/80 [50%] comments) as the most valuable use-case and "skill" as a personal barrier (20/73 [27.4%] comments). Personal and departmental barriers were not rated highly, although registrars perceived "lack of a structured training program" as a barrier. Respondents were equivocal in the value they gave point-of-care ultrasound during cardiac arrest but saw greater value when conducted by a skilled operator.

Conclusions: Point-of-care ultrasound was reported to be infrequently used in cardiac arrest, mostly due to self-perceived skill and lack of a structured training program.

Keywords: Cardiac arrest; Consultants; Heart arrest; Point-of-care; Prevalence; Surveys and questionnaires; Victoria; ultrasound.

MeSH terms

Adult
Attitude of Health Personnel*
Cross-Sectional Studies
Female
Heart Arrest* / diagnostic imaging
Heart Arrest* / therapy
Humans
Intensive Care Units*
Male
Middle Aged
Point-of-Care Systems* / statistics & numerical data
Surveys and Questionnaires
Ultrasonography / statistics & numerical data
Victoria