Echo-Guided Life Support

EGLS: Echo-Guided Life Support
An algorithmic approach to undifferentiated shock

Crit Ultrasound J (2011) 3:123–129

The EGLS algorithm 

“Airway–Breathing–Circulation” sequence of 5 questions:
  1. Is there a pneumothorax?
  2. Is tamponade present?
  3. Is the patient hypovolemic?
  4. If poor LV function is noted, is it the main cause of shock?
  5. Are there signs of RV strain?

Etiologies of shock and associated ultrasound findings

• Tension pneumothorax: Abolished lung sliding, no B-lines
• Tamponade: Pericardial effusion with RV and RA diastolic collapse, plethoric IVC, dynamic LV
• Hypovolemia: Hyperdynamic LV, IVC collapse, clear lungs
• Massive pulmonary embolism: Dilated RV, “D-shape” LV, paradoxical septal wall movement, plethoric IVC
• Myocardial infarction: Poor LV function associated with B-profile and plethoric IVC if cardiogenic shock
• Toxicological, electrolyte abnormalities, acid-base disorders: Could be associated with depressed cardiac function