SLICE: An algorithm for incorporating ultrasonography in the assessment of shocked or breathless patients
Huge gratitude to Lorena Zhang CCPU, Justin Bowra, Minh-Tu Duong & the Royal North Shore Hospital Team in Sydney, NSW for sharing their research.
SLICE is an algorithm for the integration of point-of-care ultrasound in the assessment and resuscitation of the shocked or breathless patient. It aims to determine the patient’s fluid status, and identify reversible causes for the patient’s clinical pic- ture. SLICE stands for ‘In a patient who is Shocked/Short of breath, scan the Lungs, IVC, Cardiac and Extra regions as indicated’. Its key advan- tages are that it explicitly guides resuscitative fluid management, can be performed rapidly and by clini- cians with a broad range of sono- graphic experience, and can be used in a broad range of clinical scenarios. Its use has been successfully taught and implemented in routine clinical practice at our local institution.
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Summary of the SLICE Protocol:
Conclusion: SLICE describes an algorithmic approach for the use and interpreta- tion of ultrasound in the shocked or short of breath patient. It involves sequential scanning of the lung, IVC, heart and extra views in order to guide intravenous fluid therapy and to identify a reversible cause of the patient’s haemodynamic instability. It is easy to perform, adaptable to the clinical scenario and directly guides resuscitation. Implementation and validation studies may further investi- gate its applicability to clinical prac- tice, and impact on patient outcomes.
Learn more from Dr Justin Bowra's Talk; A New POCUS Paradigm in Shock.
POCUS: A New Algorithm for the Unstable Patient