Advancing Advanced Cardiovascular Life Support With Point-of-Care Ultrasound: Is It Time to Let Go of Pulse Checks? (Sponsored by AEUS)

Current American Heart Association guidelines recommend manual pulse checks to assess return of spontaneous circulation during cardiac arrest, despite evidence demonstrating poor accuracy, reported as low as 54%. A growing body of literature suggests that point-of-care ultrasound can improve both the speed and accuracy of return-of-spontaneous-circulation identification compared with manual palpation, while also providing physiologic information that may guide resuscitative decision-making.

This session will review three ultrasound-based techniques for assessing circulation during cardiac arrest: cardiac compression assessment, color flow Doppler, and pulsed-wave Doppler. Faculty will discuss the strengths and limitations of each approach, including operator dependence and concerns regarding increased hands-off time, and will present strategies to mitigate these risks. The session will then explore an emerging paradigm shift: replacing traditional pulse checks with focused transthoracic echocardiography. Applications discussed will include optimizing compression location, differentiating pseudo–pulseless electrical activity from true pulseless electrical activity, and guiding targeted interventions.

The session will conclude with practical strategies for integrating point-of-care ultrasound into Advanced Cardiovascular Life Support workflows while minimizing interruptions to chest compressions and enhancing team performance.