Abstract Introduction: This study aimed to determine the barriers and difficulties of doing point-of-care ultrasound (POCUS) in cardiac arrest cases in the emergency department (ED). Further, to assess the awareness and appreciation of POCUS's importance and whether there was a correlation between emergency physician training and the performance of POCUS in cardiac arrest. Methods: A cross-sectional study was conducted from December 2024 to February 2025 targeting all emergency physicians in various cities in Saudi Arabia. The pediatricians and obstetrics and gynecology (OB/GYNs) physicians were excluded. All selected hospitals had at least four hundred bed capacity. Approximately 250 physicians worked in the selected centers. A Google form link of the questionnaire was sent to every participant. The response rate of 81.6% was achieved. Results: Total of 204 physicians were included in the study. Most of the participants believed in the benefits of using POCUS in cardiac arrest (71.6%). Further, 85.3% of the participants had some way of ultrasound teaching methods. Obvious barriers to using ultrasound; poor quality or large size of the ultrasound machine, lack of training, and not feeling comfortable to make clinical decisions depending on the ultrasound reading during cardiac arrest were the main barriers. Conclusion: This study revealed several ED POCUS barriers during cardiac arrest. Moving these obstacles aside with focused training, better tools, and departmental support might improve POCUS's efficacy and utilization in critical care.

Keywords: Keywords: Point of care ultrasound, cardiac arrest, bedside ultrasound, ultrasound, Saudi Arabia