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The “5Es” of Emergency Physician–performed Focused Cardiac Ultrasound: A Protocol for Rapid Identification of Effusion, Ejection, Equality, Exit, and Entrance
Author(s) -
Kennedy Hall M.,
Coffey E. C.,
Herbst Meghan,
Liu Rachel,
Pare Joseph R.,
Andrew Taylor R.,
Thomas Sheeja,
Moore Chris L.
Publication year - 2015
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/acem.12652
Subject(s) - medicine , pericardial effusion , emergency ultrasound , emergency department , emergency physician , protocol (science) , inferior vena cava , intravascular volume status , radiology , cardiac ultrasound , intensive care medicine , medical emergency , ultrasound , cardiology , hemodynamics , nursing , pathology , alternative medicine
Abstract Emergency physician ( EP )‐performed focused cardiac ultrasound ( EP FOCUS ) has been increasingly recognized as a crucial tool to help clinicians diagnose and treat potentially life‐threatening conditions. The existing literature demonstrates a variety of EP FOCUS applications and protocols; however, EP FOCUS is not taught, practiced, or interpreted consistently between institutions. Drawing on over 12 years of experience in a large‐volume, high‐acuity academic emergency department, we have developed a protocol for teaching and performing EP FOCUS known as “The 5Es,” where each E represents a specific assessment for immediately relevant clinical information. These include pericardial effusion, qualitative left ventricular ejection, ventricular equality, exit (aortic root diameter), and entrance (inferior vena cava diameter and respirophasic variation). Each of these assessments has been well described in the emergency medicine literature and is within the scope of EP ‐performed echocardiography. This approach provides a reliable and easily recalled framework for assessing, teaching, and communicating EP FOCUS findings that are essential in caring for the patient in the emergency setting.