Abstract
IntroductionCommon carotid flow measurements may be clinically useful to determine volume responsiveness. The objective of this study was to assess the ability of emergency physicians (EP) to obtain sonographic images and measurements of the common carotid artery velocity time integral (VTi) for potential use in assessing volume responsiveness in the clinical setting.MethodsIn this prospective observational study, we showed a five-minute instructional video demonstrating a technique to obtain common carotid ultrasound images and measure the common carotid VTi to emergency medicine (EM) residents. Participants were then asked to image the common carotid artery and obtain VTi measurements. Expert sonographers observed participants imaging in real time and recorded their performance on nine performance measures. An expert sonographer graded image quality. Participants were timed and answered questions regarding ease of examination and their confidence in obtaining the images.ResultsA total of 30 EM residents participated in this study and each performed the examination twice. Average time required to complete one examination was 2.9 minutes (95% CI [2.4–3.4 min]). Participants successfully completed all performance measures greater than 75% of the time, with the exception of obtaining measurements during systole, which was completed in 65% of examinations. Median resident overall confidence in accurately performing carotid VTi measurements was 3 (on a scale of 1 [not confident] to 5 [confident]).ConclusionEM residents at our institution learned the technique for obtaining common carotid artery Doppler flow measurements after viewing a brief instructional video. When assessed at performing this examination, they completed several performance measures with greater than 75% success. No differences were found between novice and experienced groups.
Highlights
Common carotid flow measurements may be clinically useful to determine volume responsiveness
Participants successfully completed all performance measures greater than 75% of the time, with the exception of obtaining measurements during systole, which was completed in 65% of examinations
emergency medicine (EM) residents at our institution learned the technique for obtaining common carotid artery Doppler flow measurements after viewing a brief instructional video
Summary
Common carotid flow measurements may be clinically useful to determine volume responsiveness. In septic patients in particular, improvements in mortality have been linked to early and aggressive volume resuscitation.[1,2] recent research demonstrates increased mortality and increased length of stay in patients with over-aggressive volume resuscitation.[3,4] it is important for EPs to have accurate diagnostic tools to Carotid Doppler Flow Measurements to Assess Volume Responsiveness determine which patient will have an increase in their stroke volume, and cardiac output, with additional intravenous fluids. This concept is frequently termed volume responsiveness. Ill, unstable patients who are not volume responsive, but are given additional fluids, will not improve their hemodynamics and may, be harmed via the resulting volume overload
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
