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Lung Ultrasound as the First Step of Management of a Cardiac Arrest: The SESAME-Protocol

  • Daniel A. Lichtenstein

Abstract

In cardiac arrest, the SESAME-protocol proposes to scan first the lung for two major targets: pneumothorax and clearance for fluid therapy. This information can be obtained in less than 5 s, i.e., a minimal hindrance in the course of resuscitation.

The SESAME-protocol then scans the lower femoral veins and the belly (first if trauma), for detecting pulmonary embolism or massive bleeding.

Then a pericardial tamponade is sought for.

Cardiac causes then follow, in position 5.

Keywords

Pulmonary Embolism Cardiac Arrest Fluid Therapy Massive Pulmonary Embolism Lung Ultrasound 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Video 31.1

Pericardial tamponade. This video clip shows for the youngest a basic pericardial tamponade from a subcostal window. The heart is recognized, beating, and surrounded by an external line: pericardial effusion is diagnosed. This effusion is substantial (20 mm at the inferior aspect). The right cardiac cavities are collapsed, indicating here a tamponade (MOV 2502 kb)

Video 31.2

Asystole. Nothing much to be written here. A few seconds were necessary for recording this loop. This is a fresh cardiac arrest, maybe the visible floating sludge is a sign of recent arrest (good neurological recovery after ROSC in this hypoxic arrest) (MOV 2502 kb)

References

  1. 1.
    Fuhlbrigge A, Choi A (2012) Diagnostic procedures in respiratory diseases. In: Harrison’s principles of internal medicine, 18th edn. McGraw-Hill, New York, p 2098Google Scholar
  2. 2.
    Lichtenstein D, Mezière G (2008) Relevance of lung ultrasound in the diagnosis of acute respiratory failure. The BLUE-protocol. Chest 134:117–125CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Lichtenstein D, Mezière G, Lagoueyte JF, Biderman P, Goldstein I, Gepner A (2009) A-lines and B-lines: lung ultrasound as a bedside tool for predicting pulmonary artery occlusion pressure in the critically ill. Chest 136:1014–1020CrossRefPubMedGoogle Scholar
  4. 4.
    Lichtenstein D (2015) BLUE-protocol and FALLS-protocol, two applications of lung ultrasound in the critically ill. Chest 147:1659–1670Google Scholar
  5. 5.
    Goldhaber SZ (2002) Echocardiography in the management of pulmonary embolism. Ann Intern Med 136:691–700CrossRefPubMedGoogle Scholar
  6. 6.
    Schmidt GA (1998) Pulmonary embolic disorders. In: Hall JB, Schmidt GA, Wood LDH (eds) Principles of critical care, 2nd edn. McGraw Hill, New York, pp 427–449Google Scholar
  7. 7.
    Blaivas M, Fox JC (2001) Outcome in cardiac arrest patients found to have cardiac standstill on the bedside E.R. department echocardiogram. Acad Emerg Med 8:616–621CrossRefPubMedGoogle Scholar
  8. 8.
    Soleil C, Plaisance P (2003) Management of cardiac arrest. Réanimation 12:153–159CrossRefGoogle Scholar
  9. 9.
    Salen P, O’Connor R, Sierzenski P et al (2001) Can cardiac sonography and capnography be used independently and in combination to predict resuscitation outcomes? Acad Emerg Med 8:610–615CrossRefPubMedGoogle Scholar
  10. 10.
    Breitkreutz R, Walcher F, Seeger FH (2007) Focused echocardiographic evaluation in resuscitation management: concept of an advanced life support-conformed algorithm. Crit Care Med 35:S150–S161CrossRefPubMedGoogle Scholar
  11. 11.
    van der Werf TS, Zijlstra JG (2004) Ultrasound of the lung: just imagine. Intensive Care Med 30:183–184CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Daniel A. Lichtenstein
    • 1
  1. 1.Hôpital Ambroise Paré Service de Réanimation MédicaleBoulogne (Paris-West University)France

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