Pulse Control Using USG and Manual Palpation Methods in Cardiopulmonary Resuscitation

Evaluation of the Effectiveness of the Carotid Arteries in Pulse Control Using USG and Manual Palpation Methods in Cardiopulmonary Resuscitation

The final approach adopted in Advanced Cardiac Life Support (ACLS) guidelines as defined by the American Heart Association (AHA) and the European Resuscitation Council (ERC) is to minimize the time between chest compressions in cardiopulmonary resuscitation (CPR). Pulse and rhythm checks are recommended between chest compressions and it is stated that this period should not exceed 10 seconds.

All guidelines also state that in cases of low cardiac output or low blood pressure, even if electrocardiographic (ECG) rhythms can be obtained, pulse checks may still fail and an arterial pulse may not be felt during chest compressions. This difficulty in sensing the arterial pulse causes delays in the decision of cardiac arrest in the patient. For this reason, there are cases of cardiac arrest in which the initiation of CPR is delayed or not started at all.

The most common method for checking the pulse is manual palpation. However, since it is an operator-dependent method, it is affected by the experience of the healthcare personnel, the vital values of the patient, and anatomical differences. Therefore, more objective criteria are required to detect a pulse. A clinical study of the reliability of pulse checks showed that most healthcare professionals are unable to detect the presence or absence of a pulse. Another study showed that pulse alone is not sufficient to initiate CPR, and 50% of decisions to initiate CPR based on heart rate are incorrect. Therefore, more objective criteria have been sought to detect the presence of a pulse. For this purpose, evaluations were made regarding the presence of end-tidal carbon dioxide, cardiac echo, and organized rhythm.

Study Overview

• Status: Completed
• Conditions: Cardiopulmonary Resuscitation
• Intervention / Treatment: Procedure: cardiopulmonary resuscitation

• Study Type: Observational
• Enrollment (Actual): 536

Contacts and Locations

Study Locations

• Turkey
  • İzmir, Turkey, 35360
    • IKCU, Atatürk Eğitim ve Araştırma Hastanesi, Acil Tıp

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 100 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

patients over 18 years old

Description

Inclusion Criteria:

• All adult patients (over 18 years of age) with in-hospital or out-of-hospital cardiac arrest

Exclusion Criteria:

• Patients with traumatic arrest
• Conditions affecting carotid pulse palpation and/or USG application (patients with a history of carotid stenosis or dissection, patients undergoing neck surgery, patients with neck abscess hematoma)
• Pregnant arrest patients

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Carotid artery pulse control result using manual and USG in cardiopulmonary resuscitation	Our aim is to compare the USG and manual methods in evaluating the presence of a pulse during CPR and to determine which method gives the most appropriate time and accuracy.	2 minute

Collaborators and Investigators

• Sponsor: Izmir Katip Celebi University

Study record dates

Study Major Dates

• Study Start (Actual): December 25, 2021
• Primary Completion (Actual): September 15, 2022
• Study Completion (Actual): September 16, 2022

Study Registration Dates

• First Submitted: September 17, 2022
• First Submitted That Met QC Criteria: September 22, 2022
• First Posted (Actual): September 27, 2022

Study Record Updates

• Last Update Posted (Actual): September 22, 2023
• Last Update Submitted That Met QC Criteria: September 21, 2023
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Keywords: carotid artery; Cardiopulmonary Arrest; pulse check
• Other Study ID Numbers: 2021-GOKAE-0536

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: All data and statistical analyzes will be shared with academics and official institutions requesting the patient's names, provided that they remain confidential, after the permission of the institution.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No