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FALLS protocol
From WikEM
Contents
Background
- The FALLS-protocol is an ultrasound evaluation of patients with acute circulatory failure
- Includes evaluation of the pleura, lungs, and pericardium using ultrasound in a step-wise fashion to categorize circulatory shock is present according to Weil's shock classification
FALLS-Protocol[1]
Appropriate Patient
A shocked patient who presents initially with an A-profile - termed a FALLS-responder
Endpoints
Prior to FALLS Protocol (BLUE-Protocol)
- Obstructive shock - Tamponade or pneumothorax on initial ultrasound
- Cardiogenic shock - B-profile on itial ultrasound
With FALLS Protocol
- Hypovolemic shock - Improvement after IVF
- Septic shock - B-profile and continued failure after IVF
Limitations
- Patients presenting with B-profile have a larger differential such as cardiogenic shock, pulmonary fibrosis, diastolic failure, etc
- Cardiogenic shock with no lung edema - e.g. right ventricular infarction - are associated with an A-profile
See Also
References
- ↑ Lichtenstein D. FALLS-protocol: lung ultrasound in hemodynamic assessment of shock. Heart, Lung and Vessels 2013; 5(3):142-147.
Authors
Gustavo Martins, Ross Donaldson, Neil Young, Daniel Ostermayer
