FALLS protocol

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

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 u/s
• Cardiogenic shock - B-profile on itial u/s

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

• Ultrasound (Main)