Assess, improve, detect, guide: a narrative review and proposal for a standardized protocol for prehospital transesophageal echocardiography during out-of-hospital cardiac arrest

Stephan Katzenschlager; Thomas Hamp; Maximilian Dietrich; Christopher T. Edmunds; Nikolai Kaltschmidt; Markus A. Weigand; Mario Krammel; Frank Weilbacher; Erik Popp

Assess, improve, detect, guide: a narrative review and proposal for a standardized protocol for prehospital transesophageal echocardiography during out-of-hospital cardiac arrest

Authors

Stephan Katzenschlager Medical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
Thomas Hamp Emergency Medical Service Vienna, Vienna, Austria; Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Medical University of Vienna, Vienna, Austria
Maximilian Dietrich Medical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
Christopher T. Edmunds Department of Research, Audit, Innovation, and Development, East Anglian Air Ambulance, Gambling Close, Norwich Airport, Norwich NR6 6EG, UK; University of East Anglia, Norwich, UK; Critical Care, North West Anglian Foundation Trust, Peterborough, UK
Nikolai Kaltschmidt Medical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
Markus A. Weigand Medical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
Mario Krammel Emergency Medical Service Vienna, Vienna, Austria; PULS Austrian Cardiac Arrest Awareness Association, Vienna, Austria
Frank Weilbacher Medical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany
Erik Popp Medical Faculty Heidelberg, Department of Anesthesiology, Heidelberg University, Im Neuenheimer Feld 420, 69120 Heidelberg, Germany

Keywords:

Transoesophageal echocardiography, Out-of-hospital cardiac arrest, Advanced life support, Prehospital, Emergency medical service

Abstract

While there are different protocols for in-hospital transesophageal echocardiography, there is no existing protocol for prehospital usage during out-of-hospital cardiac arrest. Herein, the “assess-improve-detect-guide” protocol is described. This protocol includes four mid-esophageal views to address the most time-sensitive aspects during outof-hospital cardiac arrest. This protocol can be used in services with and without the capability for eCPR, with the benefit of profiting from additional diagnostic and personal resources. This protocol provides a standardized approach for performing transesophageal echocardiography during out-of-hospital cardiac arrest and reporting the results.

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Assess, improve, detect, guide: a narrative review and proposal for a standardized protocol for prehospital transesophageal echocardiography during out-of-hospital cardiac arrest