Evidence map›Paper›PMID 40248467›Full record

ArticleTurkish journal of emergency medicine

Validation of the echoSHOCK protocol for diagnosing the cause of shock in patients arriving at the emergency department.

Takshak Shankar, Nidhi Kaeley, Parvathy Sasidharan, Archana Bairwa, M S Salva Ameena, Sreejith Jayachandran, Jewel Rani Jose, Jitendra Kumar Yadav

Abstract read
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Article in Turkish journal of emergency medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Takshak ShankarDepartment of Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0000-0002-1356-7351
Nidhi KaeleyDepartment of Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0000-0003-4358-2832
Parvathy SasidharanDepartment of Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0009-0008-8065-1175
Archana BairwaDepartment of Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0009-0001-7199-1396
M S Salva AmeenaDepartment of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India.ORCID https://orcid.org/0000-0002-3181-1792
Sreejith JayachandranDepartment of Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0009-0005-6894-8281
Jewel Rani JoseDepartment of Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0009-0009-6532-9433
Jitendra Kumar YadavDepartment of Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID https://orcid.org/0009-0001-0006-9302

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesNontraumatic undifferentiated shock is difficult to manage in the emergency department due to unclear causes, lack of history, and rapid patient deterioration. Timely and appropriate resuscitation is crucial, but both inadequate and excessive resuscitation increase mortality risks. Focused cardiac ultrasound (FoCUS) offers a timely and noninvasive cardiac assessment. The echoSHOCK protocol is derived from FoCUS and improves the ability to identify the etiology of shock in patients at the emergency department. This study's primary objective was to validate the echoSHOCK protocol for diagnosing the cause of shock in patients arriving at the emergency department. This study's secondary objective was to determine the prevalence of different etiologies of shock in patients arriving at the emergency department.

methodsAdult patients presenting to the emergency department in shock were included in the study after informed consent was obtained. The shock was defined as a systolic blood pressure of <90 mmHg or a mean arterial pressure of <65 mmHg with signs of poor tissue perfusion. Each patient underwent a detailed history, physical examination, and standard investigations. Clinicians reported a presumed etiology and management plan with a confidence level (0-10). The echoSHOCK protocol was then executed and its results were recorded with the respective confidence levels. The protocol used a phased array probe in B-mode solely and assessed left ventricle function, compressive pericardial effusion, right ventricular dilatation, interventricular septum flattening, and indicators of hypovolemia. The time taken to perform the protocol and the difficulty level were noted. An expert panel followed the patient till hospital discharge and provided the final diagnosis and intervention.

resultsThe study enrolled 223 patients with a mean age of 49.12 years. The echoSHOCK protocol showed a 94.2% agreement with expert panel diagnoses on the cause of shock and proposed interventions, with a statistically significant near-perfect agreement (Cohen's Kappa -0.896,

conclusionThe echoSHOCK protocol rapidly identifies shock etiology in patients at the emergency department. This aids in rapid resuscitation.

Indexed as

Emergencyshockultrasound

Identifiers

PMID40248467
PMCPMC12002151

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.