Cardiac Standstill on Ultrasound Predicts Futile Trauma Resuscitation

Although fewer than 1 in 20 trauma victims who arrive at the emergency department (ED) pulseless survive, such patients often undergo prolonged resuscitation attempts. These authors investigated use of bedside cardiac ultrasound by emergency physicians to predict survival in such patients.

In a retrospective study of 318 patients who presented to a level 1 trauma center without a pulse from 2002 to 2008, 162 had documentation of cardiac ultrasound. Cardiac activity was detected in 20 patients. The rate of survival to hospital admission was 30% among patients with ultrasonographic cardiac activity versus 0.7% among those without. Absence of cardiac motion on ultrasound had a negative predictive value of 99% for survival to hospital admission.…