Dallas 2015 TFQO: Michael W. Donnino COI# EVREVs: Katherine M. Berg COI# Lars W. Andersen COI# Taskforce: ALS Ultrasound During CPR

Dallas 2015 COI Disclosure (specific to this systematic review) Commercial/industry None Potential intellectual conflicts None

Dallas CoSTR Although there are several case series, no studies specifically examine the impact of ultrasound or echocardiography on patient outcomes in cardiac arrest.

Dallas 2015 C2015 PICO Population: adults who are in cardiac arrest in any setting Intervention: use of ultrasound (including echocardiography or other organ assessments) during CPR Comparison: standard CPR and resuscitation without use of ultrasound Outcomes: Survival with Favorable neurological/functional outcome at discharge, 30 days, 60 days, 180 days AND/OR 1 year, Survival only at discharge, 30 days, 60 days, 180 days AND/OR 1 year, ROSC

Dallas 2015 Inclusion/Exclusion & Articles Found List Inclusions/Exclusions Inclusion criteria: human studies of adult cardiac arrest and ultrasonography, peer- review Exclusion criteria: review articles and case reports, case series, not pertinent studies. Number of Articles Finally Evaluated: 536 excluded, 2 included

Dallas 2015 Risk of Bias in studies * Only did US on patients with post-resuscitation PEA

Dallas 2015 GRADE evaluation GRADE process was not carried out due to the lack of relevant evidence and consequent inability to address the PICO question with the available studies.

Dallas 2015 Knowledge Gaps (eg. ETT vs BVM) It remains unclear if the addition of US during CPR improves outcomes. The vast majority of literature on US during cardiac arrest has focused on the prognostic value of cardiac US findings. Randomized trials investigating whether use of US during CPR has an effect on patient outcomes are needed.