The ER patient

Series of follow-up meetings on the management of clinical cases in the emergency setting. Edited by residents and tutors of Emergency Medicine Department

Transesophageal echocardiography for emergency physicians

Dr Sergio Bevilacqua, Dr Eleonora de Villa and Dr Peiman Nazerian

BACKGROUND:

Emergency physicians frequently employ transthoracic focused cardiac ultrasound to assist in diagnosis, therapy, and prognosis during cardiac arrest and peri-arrest, but the acquisition of adequate images can be suboptimal in critically ill patients; these limitations could be overcome thanks to a “privileged” window, using transesophageal echocardiography

COURSE ORGANISATION:  

Lectures: TEE principles; demonstration of basic two-dimensional echocardiographic images obtained from the different views; identification of normal anatomy and pathologic findings of different video loops

Training: 4 days in cardiac surgery operating rooms. The tutor (a cardiothoracic anesthesiologist) will guide the participants to the acquisition of manual and interpretative skills through the execution of >10 supervised studies

After the 4 days training: exam for skills assessment (probe insertion, images acquisition and interpretation) by the tutor

After 6 and 12 weeks : refresh training and re-evaluation of skills maintenance by the tutor