Using Ultrasound to Manage Cardiac Arrest: A Practical Guide for Clinicians (Part 1)

Ultrasound serves as a critical diagnostic and procedural tool in arrest and peri-arrest management, focusing on identifying reversible causes, facilitating procedures, and verifying pulse status. Clinicians utilize bedside imaging to detect tamponade, hypovolemia, tension pneumothorax, and thrombotic events like myocardial infarction or pulmonary embolism. Regional wall motion abnormalities provide immediate insight into ischemic coronary distributions, while right heart enlargement and the McConnell sign help confirm pulmonary embolism. Beyond diagnostics, ultrasound guidance improves the accuracy of pericardiocentesis and central line placement. Because manual pulse checks are notoriously unreliable, ultrasound offers objective visual confirmation of cardiac activity, helping distinguish between perfusing rhythms and pulseless electrical activity. Integrating these sonographic findings into the ACLS algorithm allows for more precise, evidence-based decision-making during high-stakes resuscitation efforts.