Summary: Out-of-hospital cardiac arrest (OHCA) presents multiple challenges for prehospital providers. The management of cardiac arrest is of the top priority for prehospital providers and medical directors alike, with the focus always on ways to improve management of this condition. To improve OHCA outcomes in a large urban ground-based EMS service, a Point of Care Ultrasound (POCUS) program was developed and implemented. This program highlights the utility of POCUS during pulse checks as well as the identification of cardiac motion during resuscitation. A unique condition in cardiac arrest, identified as pseudoPEA or Pulseless Rhythm with Echocardiographic Motion (PREM), occurs when Pulseless electrical activity (PEA) is noted on the monitor, no palpable pulse is noted, but there is cardiac motion on POCUS. Since this EMS POCUS program started one year ago, there have been multiple cases of PREM noted. In this series of patients, resuscitation efforts would have been terminated in the field per traditional EMS guidelines without the use of POCUS. This led to the creation of one of the first protocols in an American ground ambulance service focused on the treatment of this condition. This tabletop presentation offers an opportunity to discuss this unique condition as well as management strategies to treat this condition, while reviewing a series of cases from the EMS POCUS program.
Rayburn et al. (Sun,) studied this question.