Miss Hannah Latta1
1Wellington Free Ambulance, Wellington, New Zealand, 2Auckland University of Technology, New Zealand, 3The Life Flight Trust Wellington, New Zealand
Introduction:
Patients who suffer an out-of-hospital cardiac arrest with a presenting rhythm of pulseless electrical activity (PEA) may receive inappropriate care when a manual pulse check is used to determine pulselessness. In a low flow shocked state, the myocardium may still contract but not produce enough forward flow to generate a palpable pulse.
The Cardiac Arrest Focused Echo (CAFE) exam uses a pre-imaging technique developed by Gaspari et al. (2021). This reduces the time spent acquiring an image and allows the paramedic to record an eight-second image during the pulse check pause. The ultrasound is completed by a paramedic who is specifically trained in Cardiac Arrest Focused Echo (CAFE) for this study.
Aim:
The aim of the study is to determine if paramedics can acquire and interpret a CAFE exam during pulse check pauses in a simulated PEA cardiac arrest.
Method:
An observational quantitative scientific inquiry following the INSPIRE reporting guideline for simulation was conducted with 15 paramedics from Wellington, New Zealand. Study Participant completed three phases from the 19th January to the 14th March 2022. Phase I included a two-hour eLearning programme. During Phase II, participants attended 4.5 hours of classroom theoretical and practical education. The classroom session included three competency-based assessments: an online knowledge test, echocardiogram skills station, and PEA cardiac arrest ultrasound integration and identification. Phase III was an assessment day wherein phase II assessments were duplicated to assess knowledge and skill retention.
Conclusion:
Preliminary review of the data suggests that paramedics can learn focused ultrasound with minimal theoretical and hands-on experience. However, the outcome from transferring these skills into the clinical environment is yet to be determined. It is hoped that integrating ultrasound into out-of-hospital cardiac arrest management using strict management protocols will improve outcomes for patients who present in PEA in the future.
Biography:
Hannah is a Critical Care Flight Paramedic working in Wellington and postgraduate university lecturer at AUT University, New Zealand. Hannah has extensive experience in the ambulance and emergency care sector and is passionate about learning and continuing education to ensure that patients receive the highest standard of care. Hannah is currently completing her doctoral studies and is investigating how ultrasound can be integrated into resuscitation of patients who are in cardiac arrest. Her research aims to identify very ‘low flow’ states associated with pseudo pulseless electrical activity.