FALLS protocol
Based on a review article[1] by David Lichtenstein[2]
What it is
The FALLS-protocol is an ultrasound evaluation based protocol for the assessment of patients with acute circulatory failure. It relies on the evaluation of the pleura, lungs and pericardium using ultrasound to in a step wise fashion try to define which type of circulatory shock is present (according to Weil's shock classification).
Endpoints
Administration of iv fluid until clinical improvement or development of a B-profile.
On which patients to use
On any patient with unexplained hemodynamic shock.
Limitations
No value in patients presenting with B-profile - no endpoint can be defined. Cardiogenic shock with no lung edema - e.g. right ventricular infarction - are associated with an A-profile.