Transesophageal echocardiography (TEE) in cardiac arrest: results of a hands-on training for a simplified TEE protocol
Abstract Background Integration of transesophageal echocardiography (TEE) with Focused Cardiac Ultrasound (FoCUS) can impact decision-making, assist in the diagnosis of reversible etiologies and help guiding resuscitation of patients with cardiac arrest. Objective To evaluate the ability of emergenc...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2020-08-01
|
| Series: | The Ultrasound Journal |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13089-020-00189-0 |
| _version_ | 1819160642120056832 |
|---|---|
| author | Peiman Nazerian Giuliano De Stefano Giovanni Albano Vera Gaspari Sergio Bevilacqua Valter Campagnolo Pierluigi Stefàno Stefano Grifoni |
| author_facet | Peiman Nazerian Giuliano De Stefano Giovanni Albano Vera Gaspari Sergio Bevilacqua Valter Campagnolo Pierluigi Stefàno Stefano Grifoni |
| author_sort | Peiman Nazerian |
| collection | DOAJ |
| description | Abstract Background Integration of transesophageal echocardiography (TEE) with Focused Cardiac Ultrasound (FoCUS) can impact decision-making, assist in the diagnosis of reversible etiologies and help guiding resuscitation of patients with cardiac arrest. Objective To evaluate the ability of emergency physicians (EPs) to obtain and maintain skills in performing resusTEE after a course with clinical training in the cardiac surgery theatre. Methods Ten EPs without previous TEE experience underwent a resusTEE course, based on a 2-h workshop and an 8-h hands-on training. The training was performed in a cardiac surgery theatre tutored by cardiovascular anesthesiologists. The six taught views were mid-esophageal four-chamber (ME4CH), mid-esophageal long axis (MELAX), mid-esophageal two-chamber (ME2CH), mid-esophageal bicaval view (MEbicaval), transgastric short axis (TGSAX) and aorta view (AOview). The EPs were evaluated by a cardiovascular anesthesiologist at the end of the course as well as after 12 weeks according to a standardized evaluation method. Once the course was completed, resusTEE exams, performed by EPs in Emergency Department (ED), were monitored for a 12-week period. Results The average assessment of the ten EPs by the tutors was higher than 4 points out of 5, both at the end of the course and after 12 weeks. Probe insertion, acquisition and interpretation of the different views scored on average more than 4 points out of 5 except for TGSAX that showed worsening after 12 weeks. Trainees performed twelve resusTEE exams in ED in patients with out-of-hospital cardiac arrest (OHCA) over 12 weeks after the course. EPs used only four out of six taught views in clinical practice, in the following order of frequency: ME4CH, AOview, MEbicaval and MELAX. Conclusions EPs, after a course with clinical training in the cardiac surgery theatre, can successfully acquire and maintain the skills needed to perform resusTEE. However, among the six views learned in the course, EPs used only four of them (ME4CH, MEbicaval, MELAX and AOview). |
| first_indexed | 2024-12-22T16:59:41Z |
| format | Article |
| id | doaj.art-fe60b621232348b8b5a599ab32b16f27 |
| institution | Directory Open Access Journal |
| issn | 2524-8987 |
| language | English |
| last_indexed | 2024-12-22T16:59:41Z |
| publishDate | 2020-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Ultrasound Journal |
| spelling | doaj.art-fe60b621232348b8b5a599ab32b16f272022-12-21T18:19:22ZengSpringerOpenThe Ultrasound Journal2524-89872020-08-011211710.1186/s13089-020-00189-0Transesophageal echocardiography (TEE) in cardiac arrest: results of a hands-on training for a simplified TEE protocolPeiman Nazerian0Giuliano De Stefano1Giovanni Albano2Vera Gaspari3Sergio Bevilacqua4Valter Campagnolo5Pierluigi Stefàno6Stefano Grifoni7Department of Emergency Medicine, Careggi University HospitalDepartment of Emergency Medicine, Careggi University HospitalDepartment of Emergency Medicine, Careggi University HospitalDepartment of Emergency Medicine, Careggi University HospitalDepartment of Anaesthesiology, Careggi University HospitalDepartment of Anaesthesiology, Careggi University HospitalDepartment of Cardiac Surgery, Careggi University HospitalDepartment of Emergency Medicine, Careggi University HospitalAbstract Background Integration of transesophageal echocardiography (TEE) with Focused Cardiac Ultrasound (FoCUS) can impact decision-making, assist in the diagnosis of reversible etiologies and help guiding resuscitation of patients with cardiac arrest. Objective To evaluate the ability of emergency physicians (EPs) to obtain and maintain skills in performing resusTEE after a course with clinical training in the cardiac surgery theatre. Methods Ten EPs without previous TEE experience underwent a resusTEE course, based on a 2-h workshop and an 8-h hands-on training. The training was performed in a cardiac surgery theatre tutored by cardiovascular anesthesiologists. The six taught views were mid-esophageal four-chamber (ME4CH), mid-esophageal long axis (MELAX), mid-esophageal two-chamber (ME2CH), mid-esophageal bicaval view (MEbicaval), transgastric short axis (TGSAX) and aorta view (AOview). The EPs were evaluated by a cardiovascular anesthesiologist at the end of the course as well as after 12 weeks according to a standardized evaluation method. Once the course was completed, resusTEE exams, performed by EPs in Emergency Department (ED), were monitored for a 12-week period. Results The average assessment of the ten EPs by the tutors was higher than 4 points out of 5, both at the end of the course and after 12 weeks. Probe insertion, acquisition and interpretation of the different views scored on average more than 4 points out of 5 except for TGSAX that showed worsening after 12 weeks. Trainees performed twelve resusTEE exams in ED in patients with out-of-hospital cardiac arrest (OHCA) over 12 weeks after the course. EPs used only four out of six taught views in clinical practice, in the following order of frequency: ME4CH, AOview, MEbicaval and MELAX. Conclusions EPs, after a course with clinical training in the cardiac surgery theatre, can successfully acquire and maintain the skills needed to perform resusTEE. However, among the six views learned in the course, EPs used only four of them (ME4CH, MEbicaval, MELAX and AOview).http://link.springer.com/article/10.1186/s13089-020-00189-0Transesophageal echocardiographyCardiocirculatory arrestEmergency medicineEmergency departmentResuscitationUltrasound |
| spellingShingle | Peiman Nazerian Giuliano De Stefano Giovanni Albano Vera Gaspari Sergio Bevilacqua Valter Campagnolo Pierluigi Stefàno Stefano Grifoni Transesophageal echocardiography (TEE) in cardiac arrest: results of a hands-on training for a simplified TEE protocol The Ultrasound Journal Transesophageal echocardiography Cardiocirculatory arrest Emergency medicine Emergency department Resuscitation Ultrasound |
| title | Transesophageal echocardiography (TEE) in cardiac arrest: results of a hands-on training for a simplified TEE protocol |
| title_full | Transesophageal echocardiography (TEE) in cardiac arrest: results of a hands-on training for a simplified TEE protocol |
| title_fullStr | Transesophageal echocardiography (TEE) in cardiac arrest: results of a hands-on training for a simplified TEE protocol |
| title_full_unstemmed | Transesophageal echocardiography (TEE) in cardiac arrest: results of a hands-on training for a simplified TEE protocol |
| title_short | Transesophageal echocardiography (TEE) in cardiac arrest: results of a hands-on training for a simplified TEE protocol |
| title_sort | transesophageal echocardiography tee in cardiac arrest results of a hands on training for a simplified tee protocol |
| topic | Transesophageal echocardiography Cardiocirculatory arrest Emergency medicine Emergency department Resuscitation Ultrasound |
| url | http://link.springer.com/article/10.1186/s13089-020-00189-0 |
| work_keys_str_mv | AT peimannazerian transesophagealechocardiographyteeincardiacarrestresultsofahandsontrainingforasimplifiedteeprotocol AT giulianodestefano transesophagealechocardiographyteeincardiacarrestresultsofahandsontrainingforasimplifiedteeprotocol AT giovannialbano transesophagealechocardiographyteeincardiacarrestresultsofahandsontrainingforasimplifiedteeprotocol AT veragaspari transesophagealechocardiographyteeincardiacarrestresultsofahandsontrainingforasimplifiedteeprotocol AT sergiobevilacqua transesophagealechocardiographyteeincardiacarrestresultsofahandsontrainingforasimplifiedteeprotocol AT valtercampagnolo transesophagealechocardiographyteeincardiacarrestresultsofahandsontrainingforasimplifiedteeprotocol AT pierluigistefano transesophagealechocardiographyteeincardiacarrestresultsofahandsontrainingforasimplifiedteeprotocol AT stefanogrifoni transesophagealechocardiographyteeincardiacarrestresultsofahandsontrainingforasimplifiedteeprotocol |