September 30, 2026 | 12pm ET

Resuscitation decisions in the emergency department are often made on impressions rather than numbers. Fluids are started or stopped, vasopressors are titrated, and endpoints are judged by feel, while the underlying physiology shifts faster than intermittent vitals can reveal. Sonography changes that calculus. Used at the bedside as a physiologic monitor rather than an imaging study alone, it lets clinicians see deranged hemodynamics as they evolve, put objective values on perfusion and volume status, and recognize the point at which continued resuscitation stops helping and begins to harm.

In this webinar, Dr. Siva explores resuscitative sonography as a quantitative tool in emergency medicine. He walks through how sonography reveals deranged physiology at the bedside, demonstrates the measurement of the perfusion index, the oxygen shift (oxygen delivery and consumption), and volume status, and discusses how those numbers translate into safer, more deliberate resuscitation. He also examines the congestion cascade, the sequence by which accumulating volume becomes its own injury, and how recognizing it early allows clinicians to shift from resuscitation to de-resuscitation. Attendees leave with a practical framework for grounding resuscitation decisions in objective hemodynamic data.

Learning objectives:

1. Explain how sonography identifies deranged physiology in the acutely ill patient.
2. Interpret objective sonographic measurements of hemodynamic status, including the perfusion index, oxygen shift, and volume status.
3. Apply quantified hemodynamic data to guide safer resuscitation.
4. Recognize the congestion cascade and identify when to initiate de-resuscitation.

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