Teran F, et al. - In this prospective observational study, researchers evaluated the extent to which transesophageal echocardiography (TEE) in the emergency department (ED) evaluation during out-of-hospital cardiac arrest (OHCA) was feasible and how it was relevant clinically. Overall, 33 adult patients with non-traumatic OHCA were included, 21 patients (64%) presented with ongoing CPR and 12 (36%) presented with return of spontaneous circulation (ROSC). After intubation, emergency physicians performed TEE. They used a 4 view protocol to assess the area of maximal compression (AMC) in order to evaluate CPR quality by using TEE intra-arrest. Findings revealed the feasibility of TEE during OHCA management, TEE was also found to be clinically impactful in these patients. Based on the findings, cardiac activity could be assessed, including identification of pseudo-PEA and fine ventricular fibrillation, reversible pathology could be detected, and CPR quality could be optimized by using resuscitative TEE.