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Posted By: Robert Dinallo
September 12, 2026
In cardiac arrests, minimizing interruptions in chest compressions during cardiac arrest is a major priority. Frequent pauses for pulse and rhythm checks can reduce chest compression fraction and potentially worsen outcomes. A recent study published in Annals of Emergency Medicine explores whether femoral arterial Doppler ultrasound waveforms obtained during active chest compressions can predict arterial line pulsatility at the next pulse check, offering a potential way to identify return of spontaneous circulation (ROSC) without stopping CPR as often.
The study focuses on a practical problem in resuscitation: clinicians currently have limited reliable methods to detect ROSC during ongoing compressions. End-tidal CO2 lacks sufficient accuracy, and existing monitoring tools do not reliably identify ROSC in real time. Femoral artery doppler ultrasound may fill this gap by visualizing arterial blood flow during CPR.
The authors identified 4 waveform types seen in the femoral artery during chest compressions:
These patterns were then compared with the presence or absence of arterial line pulsatility during the next pulse check.
In this retrospective diagnostic accuracy study, the investigators analyzed 123 Doppler ultrasound waveform/pulse-check pairs from 44 adult emergency department cardiac arrest patients with femoral arterial lines.
The major findings were: