Reply to Letter: Letter to the Editor regarding Gaspari and colleague’s “Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest”

The recent study by Gaspari et al. is commendable and contributes much to the subject matter.1Gaspari R. Weekes A. Adhikari S. et al.Emergency department point-of-care ultrasound in out-of-hospital and in-ED cardiac arrest.Resuscitation. 2016; 109: 33-39Abstract Full Text Full Text PDF PubMed Scopus (128) Google Scholar I am sure that many people will want to incorporate this information while treating their next cardiac arrest victim. To drill down what this paper means for any one patient, however, more analysis is required. The odds that a patient achieves return of spontaneous circulation — and ultimately survives to hospital discharge neurologically intact — decreases with every passing moment of the arrest.2Kim W.Y. Ahn S. Hong J.S. et al.The impact of downtime on neurologic intact survival in patients with targeted temperature management after out-of-hospital cardiac arrest: national multicenter cohort study.Resuscitation. 2016; 105: 203Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar Therefore, the association between cardiac standstill and outcome needs to be qualified as to when during the arrest the information was gleaned. I would imagine that visualizing cardiac standstill at minute-one of the resuscitation means something very different than seeing no cardiac activity forty minutes into the resuscitation. Could the authors perform an analysis reporting at which time the ultrasound was performed during resuscitation efforts? No conflicts of interests to declare.