{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T10:15:57Z","timestamp":1779099357277,"version":"3.51.4"},"reference-count":23,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:00:00Z","timestamp":1778889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Over 350,000 patients experience out-of-hospital cardiac arrest annually in the United States. Patients presenting to the emergency department (ED) in cardiac arrest are critically ill and require emergent clinical decisions and treatment. Point-of-care ultrasound (POCUS) is useful as a rapid, bedside diagnostic imaging tool to help elucidate possible causes of cardiac arrest and guide management. Using a validated systematic approach such as the SHoC and CASA protocols, clinicians can safely perform POCUS with shortened pauses during pulse checks. POCUS is key in evaluating cardiac arrhythmias such as ventricular fibrillation (VF), which has higher survival rates with defibrillation, versus cardiac standstill, which has higher mortality per recent research studies. When performed by experienced users, POCUS also facilitates identification of reversible causes for improved cardiac arrest patient outcomes and can guide decisions in resuscitative efforts. In summary, this manuscript is a narrative review that illustrates identifiable POCUS findings and synthesizes them to guide potential emergent intervention in patients in cardiac arrest including: ventricular fibrillation, cardiac standstill, pericardial effusion, cardiac tamponade, right heart strain such as from acute pulmonary embolism, reduced cardiac function, wall motion abnormality, ruptured ventricular pseudoaneurysm, and aortic dissection.<\/jats:p>","DOI":"10.3390\/diagnostics16101514","type":"journal-article","created":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T08:56:27Z","timestamp":1779094587000},"page":"1514","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Point-of-Care Ultrasound Use in Cardiac Arrest Patients"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-9376-9317","authenticated-orcid":false,"given":"Andrew G.","family":"Theophanous","sequence":"first","affiliation":[{"name":"College of Medicine, University of Toledo, 3000 Arlington Ave., Toledo, OH 43614, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5460-7252","authenticated-orcid":false,"given":"Nina","family":"Angeles","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Duke University School of Medicine, 2301 Erwin Rd., Durham, NC 27710, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"Elizondo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Duke University School of Medicine, 2301 Erwin Rd., Durham, NC 27710, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9250-9490","authenticated-orcid":false,"given":"Yuriy S.","family":"Bronshteyn","sequence":"additional","affiliation":[{"name":"Durham Veterans Affairs Healthcare System, Durham, NC 27710, USA"},{"name":"Department of Anesthesiology, Duke University School of Medicine, Durham, NC 27710, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0697-3703","authenticated-orcid":false,"given":"Rebecca G.","family":"Theophanous","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Duke University School of Medicine, 2301 Erwin Rd., Durham, NC 27710, USA"},{"name":"Durham Veterans Affairs Healthcare System, Durham, NC 27710, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e93","DOI":"10.1161\/CIR.0000000000001123","article-title":"Heart disease and stroke statistics\u20142023 update: A report from the American Heart Association","volume":"147","author":"Tsao","year":"2023","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.resuscitation.2016.09.018","article-title":"Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest","volume":"109","author":"Gaspari","year":"2016","journal-title":"Resuscitation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.ajem.2004.11.007","article-title":"Does the presence or absence of sonographically identified cardiac activity predict resuscitation outcomes of cardiac arrest patients?","volume":"23","author":"Salen","year":"2005","journal-title":"Am. J. Emerg. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1007\/s43678-022-00336-7","article-title":"Just the facts: Point-of-care ultrasound in cardiac arrest","volume":"24","author":"Gottlieb","year":"2022","journal-title":"Can. J. Emerg. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1017\/cem.2016.394","article-title":"International Federation for Emergency Medicine Consensus Statement: Sonography in hypotension and cardiac arrest (SHoC): An international consensus on the use of point of care ultrasound for undifferentiated hypotension and during cardiac arrest","volume":"19","author":"Atkinson","year":"2017","journal-title":"Can. J. Emerg. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.resuscitation.2018.07.030","article-title":"Implementation of the Cardiac Arrest Sonographic Assessment (CASA) protocol for patients with cardiac arrest is associated with shorter CPR pulse checks","volume":"131","author":"Clattenburg","year":"2018","journal-title":"Resuscitation"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.ajem.2017.08.052","article-title":"The Cardiac Arrest Sonographic Assessment (CASA) exam\u2014A standardized approach to the use of ultrasound in PEA","volume":"36","author":"Gardner","year":"2018","journal-title":"Am. J. Emerg. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1111\/j.1553-2712.2001.tb00174.x","article-title":"Outcome in Cardiac Arrest Patients Found to Have Cardiac Standstill on the Bedside Emergency Department Echocardiogram","volume":"8","author":"Blaivas","year":"2001","journal-title":"Acad. Emerg. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/S0300-9572(03)00245-4","article-title":"Emergency echocardiography to detect pericardial effusion in patients in PEA and near-PEA states","volume":"59","author":"Tayal","year":"2003","journal-title":"Resuscitation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.resuscitation.2017.09.008","article-title":"A retrospective study of pulseless electrical activity, bedside ultrasound identifies interventions during resuscitation associated with improved survival to hospital admission. A REASON Study","volume":"120","author":"Gaspari","year":"2017","journal-title":"Resuscitation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.annemergmed.2025.04.014","article-title":"Incidence and clinical relevance of echocardiography visualization of occult ventricular fibrillation: A Multicenter Prospective Study of Patients Presenting to the Emergency Department After Out-of-Hospital Cardiac Arrest","volume":"86","author":"Gaspari","year":"2025","journal-title":"Ann. Emerg. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e24-00010","DOI":"10.1097\/JTCCM-D-24-00010","article-title":"Point of care ultrasound and shock: The value in bedside diagnosis and hemodynamic assessment in undifferentiated shock patients","volume":"6","author":"Nguyen","year":"2024","journal-title":"J. Transl. Crit. Care Med."},{"key":"ref_13","first-page":"503254","article-title":"Bedside ultrasound in resuscitation and the rapid ultrasound in shock protocol","volume":"2012","author":"Seif","year":"2012","journal-title":"Crit. Care Res. Pract."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Magon, F., Longhitano, Y., Savioli, G., Piccioni, A., Tesauro, M., Del Duca, F., Napoletano, G., Volonnino, G., Maiese, A., and La Russa, R. (2024). Point-of-Care Ultrasound (POCUS) in Adult Cardiac Arrest: Clinical Review. Diagnostics, 14.","DOI":"10.3390\/diagnostics14040434"},{"key":"ref_15","first-page":"e52371","article-title":"Utilization of Point-of-Care Ultrasound as an Imaging Modality in the Emergency Department: A Systematic Review and Meta-Analysis","volume":"16","author":"Popat","year":"2024","journal-title":"Cureus"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"American College of Emergency Physicians Policy Statement (2023). Ultrasound Guidelines: Emergency, Point-of-care, Clinical Ultrasound Guidelines in Medicine. Ann. Emerg. Med., 82, e115\u2013e155.","DOI":"10.1016\/j.annemergmed.2023.06.005"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ajem.2023.07.011","article-title":"What echocardiographic findings differentiate acute pulmonary embolism and chronic pulmonary hypertension?","volume":"72","author":"Alerhand","year":"2023","journal-title":"Am. J. Emerg. Med."},{"key":"ref_18","first-page":"e009179","article-title":"Association Between 90-Minute Door-to-Balloon Time, Selective Exclusion of Myocardial Infarction Cases, and Access Site Choice: Insights from the Cardiac Care Outcomes Assessment Program (COAP) in Washington State","volume":"13","author":"Nathan","year":"2020","journal-title":"Circ. Card. Interv."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1016\/S0140-6736(14)61932-2","article-title":"Relation between door-to-balloon times and mortality after primary percutaneous coronary intervention over time: A retrospective study","volume":"385","author":"Nallamothu","year":"2015","journal-title":"Lancet"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.case.2018.11.005","article-title":"Percutaneous Closure of a Traumatic Right Ventricular Pseudoaneurysm: A Novel Interventional Approach","volume":"3","author":"Lippmann","year":"2019","journal-title":"CASE"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1186\/s13019-025-03566-9","article-title":"Successful management of a delayed-presented and complicated right ventricular pseudoaneurysm: A case report and literature review","volume":"20","author":"Bayat","year":"2025","journal-title":"J. Cardiothorac. Surg."},{"key":"ref_22","first-page":"4352474","article-title":"An Incidentally Detected Right Ventricular Pseudoaneurysm","volume":"2017","author":"Gaddipati","year":"2017","journal-title":"Case Rep. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.1016\/j.jcin.2015.04.019","article-title":"Percutaneous closure of right ventricular pseudoaneurysm","volume":"8","author":"Alkhouli","year":"2015","journal-title":"JACC Cardiovasc. 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