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Kongkatong M, Ottenhoff J, Thom C, Han D. Focused Ultrasonography in Cardiac Arrest. Emerg Med Clin North Am 2023; 41:633-675. [PMID: 37391255 DOI: 10.1016/j.emc.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
Rapid diagnostic tools available to the emergency physician caring for cardiac arrest patients are limited. Focused ultrasound (US), and in particular, focused echocardiography, is a useful tool in the evaluation of patients in cardiac arrest. It can help identify possible causes of cardiac arrest like tamponade and pulmonary embolism, which can guide therapy. US can also yield prognostic information, with lack of cardiac activity being highly specific for failure to achieve return of spontaneous circulation. US may also be used to aid in procedural guidance. Recently, focused transesophageal echocardiography has been used in the emergency department setting.
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Affiliation(s)
- Matthew Kongkatong
- Department of Emergency Medicine, University of Virginia Health, 1215 Lee Street, Charlottesville, VA 22908, USA.
| | - Jakob Ottenhoff
- Department of Emergency Medicine, University of Virginia Health, 1215 Lee Street, Charlottesville, VA 22908, USA
| | - Christopher Thom
- Department of Emergency Medicine, University of Virginia Health, 1215 Lee Street, Charlottesville, VA 22908, USA
| | - David Han
- Department of Emergency Medicine, University of Virginia Health, 1215 Lee Street, Charlottesville, VA 22908, USA
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2
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Kegel F, Chenkin J. Resuscitative transesophageal echocardiography in the emergency department: a single-centre case series. Scand J Trauma Resusc Emerg Med 2023; 31:24. [PMID: 37210538 DOI: 10.1186/s13049-023-01077-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/10/2023] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND Transesophageal echocardiography (TEE) is an emerging tool that can aid emergency physicians in treating patients in cardiac arrest and undifferentiated shock. TEE can aid in diagnosis, resuscitation, identify cardiac rhythms, guide chest compression vectors, and shorten sonographic pulse checks. This study evaluated the proportion of patients who underwent a change in their resuscitation management as a result of emergency department resuscitative TEE. METHODS This was a single-centre case series of 25 patients who underwent ED resuscitative TEE from 2015 to 2019. The objective of this study is to evaluate the feasibility and clinical impact of resuscitative TEE in critically ill patients in the emergency department. Data including changes in working diagnosis, complications, patient disposition, and survival to hospital discharge were also collected. RESULTS 25 patients (median age 71, 40% female) underwent ED resuscitative TEE. All patients were intubated prior to probe insertion and adequate TEE views were obtained for every patient. The most common indications for resuscitative TEE were cardiac arrest (64%) and undifferentiated shock (28%). Resuscitation management changed in 76% (N = 19) and working diagnosis changed in 76% (N = 19) of patients. Ten patients died in the ED, 15 were admitted to hospital, and eight survived to hospital discharge. There were no immediate complications (0/15) and two delayed complications (2/15), both of which were minor gastrointestinal bleeding. CONCLUSIONS The use of ED resuscitative TEE is a practical modality that provides useful diagnostic and therapeutic information for critically ill patients in the emergency department, with an excellent rate of adequate cardiac visualization, and a low complication rate.
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Affiliation(s)
- Fraser Kegel
- Department of Emergency Medicine, Faculty of Medicine, University of Toronto, C. David Naylor Building, 6 Queen's Park Crescent West, Third Floor, Toronto, ON, M5S 3H2, Canada
| | - Jordan Chenkin
- Department of Emergency Medicine, Faculty of Medicine, University of Toronto, C. David Naylor Building, 6 Queen's Park Crescent West, Third Floor, Toronto, ON, M5S 3H2, Canada.
- Department of Emergency Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room AG 245, Toronto, ON, M4N 3M5, Canada.
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Chenkin J, Jelic T, Hockmann E. Optimizing simulator-based training for emergency transesophageal echocardiography: A randomized controlled trial. AEM EDUCATION AND TRAINING 2023; 7:e10845. [PMID: 36733980 PMCID: PMC9883586 DOI: 10.1002/aet2.10845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/13/2022] [Accepted: 12/28/2022] [Indexed: 06/18/2023]
Abstract
Background Resuscitative clinician-performed transesophageal echocardiography (TEE) is a relatively novel ultrasound application; however, optimal teaching methods have not been determined. Previous studies have demonstrated that variable practice (VP), where practice conditions are changed, may improve learning of procedural skills compared with blocked practice (BP), where practice conditions are kept constant. We compared VP and BP for teaching resuscitative TEE to emergency medicine residents using a simulator. Methods Emergency medicine residents with no prior TEE experience were randomized to the BP or VP groups. The BP group practiced 10 repetitions of a fixed five-view TEE sequence, while the VP group practiced 10 different random five-view TEE sequences on a simulator. Participants completed a performance assessment immediately after training and a transfer test 2 weeks after training. Ultrasound images and transducer motion metrics were captured by the simulator for blinded analysis. The primary outcome was the percentage of successful views on the transfer test. Results Twenty-eight participants completed the study (14 in the BP group, 14 in the VP group). The BP group had a higher rate of successful views compared with the VP group on the transfer test (93.6% vs. 77.6%; p = 0.002). The BP group also had higher image quality on a 5-point scale (3.3 vs. 2.9; p = 0.01) and fewer probe angular changes (2982.5 degrees vs. 4239.8 degrees; p = 0.04). There were no statistically significant differences between the groups for the rate of correct diagnoses, confidence level, or scan time. Conclusions Practicing a fixed sequence of views was more effective than a variable sequence of views for learning resuscitative TEE on a simulator. These results should be validated in TEE scans performed in the clinical environment.
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Affiliation(s)
- Jordan Chenkin
- Department of Emergency ServicesSunnybrook Health Sciences CentreTorontoOntarioCanada
- Division of Emergency MedicineUniversity of TorontoTorontoOntarioCanada
| | - Tomislav Jelic
- Adult EmergencyHealth Sciences CentreWinnipegManitobaCanada
| | - Edgar Hockmann
- Division of Emergency MedicineUniversity of TorontoTorontoOntarioCanada
- Department of AnaesthesiologySunnybrook Health Sciences CentreTorontoOntarioCanada
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Field S, Aust Z, Potomac W, Pascual M, Couch C, Bhatia D, Dixon B, Upchurch B, Zozaya J, Jones J, Hansen Z, Roppolo L. An Innovative Curriculum For Teaching Transesophageal Echocardiography (TEE) to Emergency Medicine Residents. J Emerg Med 2022; 63:801-810. [PMID: 36369119 DOI: 10.1016/j.jemermed.2022.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/23/2022] [Accepted: 09/04/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Focused transesophageal echocardiogram (TEE) can be a valuable tool for emergency physicians (EP) during cardiac arrest. OBJECTIVES We sought to demonstrate the ability of emergency medicine (EM) residents without prior TEE experience to perform a simulated four-view TEE following a short, flipped conference curriculum. METHODS This was a prospective, simulation-based study where EM residents participated in the following four-view TEE curriculum: 1 h of online content reviewed prior to a 20-min in-person lecture and 30-min hands-on practice using a TEE trainer. Each resident attended four testing sessions over an 8-week period and performed a total of 25 TEE scans. Each TEE scan was graded in real time using a 10-point checklist by a TEE-credentialed EP. Interrater reliability of the checklist was calculated using the kappa coefficient (κ). A random sample of 10% of the TEE scans were reviewed by a TEE expert using a standard ultrasound 1-5 scale for image acquisition quality, with a "3" considered to be satisfactory. Residents completed an online pretest and posttest. RESULTS Twenty-four residents participated. Mean pre- and posttest scores were 52% (SD 16) and 92% (SD 12), respectively. Mean TEE scores using the 10-point checklist after sessions one and four were 9.4 (SD 0.4) and 9.7 (SD 0.3), respectively. Mean time to complete each TEE scan after sessions one and four were 118.1 (SD 28.3) and 57.1 (SD 17.0) s, respectively. The κ for the checklist was 1. The median score for the image acquisition review was 3 (interquartile range 3-4). CONCLUSIONS This simplified flipped conference curriculum can train EM residents to competently perform TEE in a simulated environment.
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Affiliation(s)
- Steven Field
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas
| | - Zachary Aust
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas
| | - Whitney Potomac
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas
| | - Mandy Pascual
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas
| | - Christopher Couch
- Cardiovascular Intensive Care Unit, Medical City Dallas Heart Hospital, Dallas, Texas
| | - Deven Bhatia
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas
| | - Bryant Dixon
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas
| | - Bradley Upchurch
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas
| | - Josue Zozaya
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas
| | - Jodi Jones
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas
| | - Zachary Hansen
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas
| | - Lynn Roppolo
- Department of Emergency Medicine, University of Texas Southwestern, Dallas, Texas
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Gottlieb M, Alerhand S. Managing Cardiac Arrest Using Ultrasound. Ann Emerg Med 2022; 81:532-542. [PMID: 36334956 DOI: 10.1016/j.annemergmed.2022.09.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/18/2022] [Accepted: 09/20/2022] [Indexed: 11/15/2022]
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Bala S, Yerra AK, Katkuri S, Podila KS, Animalla V. Evaluation of simulation skills of healthcare workers at a tertiary care center: A perspective towards coronavirus disease 2019 (COVID-19) third wave preparation. J Family Community Med 2022; 29:102-107. [PMID: 35754749 PMCID: PMC9221233 DOI: 10.4103/jfcm.jfcm_23_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/02/2022] [Accepted: 04/13/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Simulation-based training for healthcare providers was established as an efficacious training tool to sharpen the performance skills of nontechnical team as necessary for the prevention of errors and adverse events in the pandemic. To tackle this third wave, our institute started preparations with a faculty development course of simulation-based learning to evaluate participants' knowledge and skills and their attitudes and feedback. MATERIALS AND METHODS: As part of the simulation workshop, a module was developed to train the staff on recognizing and responding to acute coronavirus disease 2019 affecting adults and children. Case-based scenarios were provided in the application. Pretest and posttest questionnaires were administered to all trainees. The questionnaires included questions on knowledge, skills confidence and attitude marked on a 5-point Likert scale. Data were entered and analyzed using the Microsoft Excel 2018. Qualitative variables were expressed as percentages, whereas mean and standard deviations were computed for quantitative variables. Paired t-test was used to test the difference between pre and post test scores; P < 0.05 was taken as significant value. RESULTS: A total of 296 participants were included in the study. A statistically significant increase in knowledge and skills confidence scores was found from pre-test to post-test. The most significant improvement was found in the assessment of pediatric hemodynamic status and the management of fluid and electrolytes. The most interesting benefit to the participants was the acquisition of knowledge about the proper use of technology after the faculty development course. CONCLUSIONS: Such workshops play a crucial role in training healthcare workers, especially as preparation for the pandemic. Most participants suggested that there should be such workshops at regular intervals to enhance their skills confidence in handling emergency situations in the clinical settings.
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Affiliation(s)
- Sudha Bala
- Department of Community Medicine, ESIC Medical College, Hyderabad, Telangana, India
| | - Aruna K Yerra
- Department of Obstetrics and Gynaecology, ESIC Medical College and Hospital, Hyderabad, Telangana, India
| | - Sushma Katkuri
- Department of Community Medicine, ESIC Medical College, Hyderabad, Telangana, India
| | - Karuna S Podila
- Department of Pharmacology, ESIC Medical College,, Hyderabad, Telangana, India
| | - Venkatesham Animalla
- Department of Community Medicine, ESIC Medical College, Hyderabad, Telangana, India
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Pulmonary Artery Cannulation Complicating Tube Thoracostomy. Ann Am Thorac Soc 2022; 19:682-684. [PMID: 35363129 DOI: 10.1513/annalsats.202105-533cc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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8
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Girón-Arango L, D’Empaire PP. Is There a Role for Transesophageal Echocardiography in the Perioperative Trauma Patient? CURRENT ANESTHESIOLOGY REPORTS 2022; 12:210-216. [PMID: 35340714 PMCID: PMC8933763 DOI: 10.1007/s40140-022-00526-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2022] [Indexed: 12/04/2022]
Abstract
Purpose of Review
This review article summarizes the advantages and potential uses of focused transesophageal echocardiography (TEE) in the perioperative period for trauma patients. We suggest a locally developed TEE protocol for trauma and provide strategies to achieve widespread use of TEE in the anesthesia care of trauma patients. Recent Findings In recent years, TEE has gained interest as an additional modality as point-of-care ultrasound (POCUS) for the resuscitation of acutely ill patients in whom transthoracic echocardiography is not feasible or non-diagnostic. Nevertheless, its use among non-cardiac anesthesiologists is still limited compared to the more traditional POCUS applications. Summary A goal-directed, focused TEE can be performed at the bedside in different locations and mechanically ventilated patients. TEE provides relevant diagnostic information to guide the resuscitation of acutely injured patients, particularly to identify life-threatening hidden thoracic injuries in the scenario of patients with multi-system trauma.
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Moslehi S, Masoumi G, Barghi-Shirazi F. Benefits of simulation-based education in hospital emergency departments: A systematic review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:40. [PMID: 35281376 PMCID: PMC8893067 DOI: 10.4103/jehp.jehp_558_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/26/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The emergency department is one of the most important parts of all hospitals. For this reason, many simulation programs are performed in this department to increase the knowledge, skills, and productivity of health-care workers. The purpose of this study was to identify the benefits of simulation in hospital emergency departments. MATERIALS AND METHODS In the present systematic study, using "AND" and "OR" operators, we searched for the keywords "benefits," "simulation," and "hospital emergency department" in PubMed, Web of Science, Scopus, Google Scholar as well as Persian language databases such SID, Magiran, Irandoc, and Iran Medex. Then, a three-step screening process was used to select studies relevant to simulation and hospital emergency from 2005 to 2021 using the PRISMA checklist, and finally, the obtained data were analyzed. RESULTS A total of three main groups, each with several subgroups, were extracted and identified as the benefits of using simulation in hospital emergency departments. They included improving the diagnosis of the disease (rapid prediction of the disease, rapid diagnosis, and patient triage), improving the treatment process (improvement of treatment results, anticipation of admission and discharge of patients, acceleration of interventions, and reduction of medical errors), and improving knowledge and skills (improvement of the speed of decision-making, staff's acquisition of knowledge and skills, simple, convenient, and low-cost training, improvement of staff's preparedness in crisis). CONCLUSION Based on the results of the present study, it is suggested to develop some training programs in order to help staff upgrade their knowledge and performance as well as acquire practical skills and also to improve the diagnosis and treatment process in hospital emergency departments. Virtual methods are also proposed to be applied as potential and cost-effective platforms for learning, teaching, and evaluating the staff of hospital emergency departments.
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Affiliation(s)
- Shandiz Moslehi
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
- Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Masoumi
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
- Emergency Management Research Center, Iran University of Medical Sciences (IUMS), Tehran, Iran
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation (USWR), Tehran, Iran
| | - Fahimeh Barghi-Shirazi
- Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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10
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PoSaw LL, Wubben BM, Bertucci N, Bell GA, Healy H, Lee S. Teaching emergency ultrasound to emergency medicine residents: a scoping review of structured training methods. J Am Coll Emerg Physicians Open 2021; 2:e12439. [PMID: 34142104 PMCID: PMC8202829 DOI: 10.1002/emp2.12439] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/28/2021] [Accepted: 02/08/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Over the past 2 decades, emergency ultrasound has become essential to patient care, and is a mandated competency for emergency medicine residency graduation. However, the best evidence regarding emergency ultrasound education in residency training is not known. We performed a scoping review to determine the (1) characteristics and (2) outcomes of published structured training methods, (3) the quality of publications, and (4) the implications for research and training. METHODS We searched broadly on multiple electronic databases and screened studies from the United States and Canada describing structured emergency ultrasound training methods for emergency medicine residents. We evaluated methodological quality with the Medical Education Research Study Quality Instrument (MERSQI), and qualitatively summarized study and intervention characteristics. RESULTS A total of 109 studies were selected from 6712 identified publications. Publications mainly reported 1 group pretest-posttest interventions (38%) conducted at a single institution (83%), training in image acquisition (82%) and interpretation (94%) domains with assessment of knowledge (44%) and skill (77%) outcomes, and training in cardiac (18%) or vascular access (15%) applications. Innovative strategies, such as gamification, cadaver models, and hand motion assessment are described. The MERSQI scores of 48 articles ranged from 0 to 15.5 (median, 11.5; interquartile range, 9.6-13.0) out of 18. Low scores reflected the absence of reported valid assessment tools (73%) and higher level outcomes (90%). CONCLUSIONS Although innovative strategies are illustrated, the overall quality of research could be improved. The use of standardized planning and assessment tools, intentionally mapped to targeted domains and outcomes, might provide valuable formative and summative information to optimize emergency ultrasound research and training.
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Affiliation(s)
- Leila L. PoSaw
- Division of Emergency MedicineJackson Memorial HospitalMiamiFloridaUSA
| | | | | | - Gregory A. Bell
- Department of Emergency MedicineUniversity of IowaIowa CityIowaUSA
| | - Heather Healy
- Hardin Library for the Health SciencesUniversity of Iowa LibrariesIowa CityIowaUSA
| | - Sangil Lee
- Department of Emergency MedicineUniversity of IowaIowa CityIowaUSA
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11
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Teran F, Prats MI, Nelson BP, Kessler R, Blaivas M, Peberdy MA, Shillcutt SK, Arntfield RT, Bahner D. Focused Transesophageal Echocardiography During Cardiac Arrest Resuscitation: JACC Review Topic of the Week. J Am Coll Cardiol 2021; 76:745-754. [PMID: 32762909 DOI: 10.1016/j.jacc.2020.05.074] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/05/2020] [Accepted: 05/21/2020] [Indexed: 12/20/2022]
Abstract
Focused transthoracic echocardiography (TTE) during cardiac arrest resuscitation can enable the characterization of myocardial activity, identify potentially treatable pathologies, assist with rhythm interpretation, and provide prognostic information. However, an important limitation of TTE is the difficulty obtaining interpretable images due to external and patient-related limiting factors. Over the last decade, focused transesophageal echocardiography (TEE) has been proposed as a tool that is ideally suited to image patients in extremis-those in cardiac arrest and periarrest states. In addition to the same diagnostic and prognostic role provided by TTE images, TEE provides unique advantages including the potential to optimize the quality of chest compressions, shorten cardiopulmonary resuscitation interruptions, guide resuscitative procedures, and provides a continuous image of myocardial activity. This review discusses the rationale, supporting evidence, opportunities, and challenges, and proposes a research agenda for the use of focused TEE in cardiac arrest with the goal to improve resuscitation outcomes.
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Affiliation(s)
- Felipe Teran
- Division of Emergency Ultrasound and Center for Resuscitation Science, Department of Emergency Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Michael I Prats
- Division of Ultrasound, Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Bret P Nelson
- Division of Ultrasound, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ross Kessler
- Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Michael Blaivas
- Department of Medicine, University of South Carolina School of Medicine. Department of Emergency Medicine, St. Francis Hospital, Columbia, South Carolina
| | - Mary Ann Peberdy
- Division of Cardiology, Department of Internal Medicine, Weil Institute of Emergency and Critical Care, Department of Emergency Medicine, University Virginia Commonwealth University, Richmond, Virginia
| | - Sasha K Shillcutt
- Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Robert T Arntfield
- Division of Critical Care Medicine, Western University, London, Ontario, Canada
| | - David Bahner
- Division of Ultrasound, Department of Emergency Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
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Rublee C, Yang B, Eisinger G, Slivnick J, Obarski T, Bahner D, Li-Sauerwine S. A Case for the Use of Transesophageal Echocardiography in the ED Treatment of Cardiac Arrest. Chest 2020; 157:e173-e176. [PMID: 32386652 DOI: 10.1016/j.chest.2019.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/10/2019] [Indexed: 10/24/2022] Open
Affiliation(s)
- Caitlin Rublee
- Department of Emergency Medicine, Ohio State University Wexner Medical Center, Columbus, OH
| | - Betty Yang
- Department of Emergency Medicine, Ohio State University Wexner Medical Center, Columbus, OH
| | - Gregory Eisinger
- Department of Emergency Medicine, Ohio State University Wexner Medical Center, Columbus, OH
| | - Jeremy Slivnick
- Department of Emergency Medicine, Ohio State University Wexner Medical Center, Columbus, OH
| | - Timothy Obarski
- Department of Emergency Medicine, Ohio State University Wexner Medical Center, Columbus, OH
| | - David Bahner
- Department of Emergency Medicine, Ohio State University Wexner Medical Center, Columbus, OH
| | - Simiao Li-Sauerwine
- Department of Emergency Medicine, Ohio State University Wexner Medical Center, Columbus, OH.
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Merlin MA, Joseph J, Hohbein J, Ariyaprakai N, Tanis J, Tagore A. Out-of-Hospital Transesophageal Echocardiogram for Cardiac Arrest Resuscitation: The Initial Case. PREHOSP EMERG CARE 2019; 24:90-93. [DOI: 10.1080/10903127.2019.1604926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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14
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Parker BK, Salerno A, Euerle BD. The Use of Transesophageal Echocardiography During Cardiac Arrest Resuscitation: A Literature Review. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1141-1151. [PMID: 30280396 DOI: 10.1002/jum.14794] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/13/2018] [Accepted: 07/13/2018] [Indexed: 06/08/2023]
Abstract
We propose that transesophageal echocardiography (TEE) can be used to guide cardiac arrest resuscitation. We undertook a literature search (Medline and EMBase) to assess articles on that topic. Our search yielded 55 articles falling into 3 categories: TEE used in operating rooms, TEE used in emergency departments, and TEE used in other settings. In many cases, TEE changed the direction of the resuscitation; however, it is unclear whether TEE changed patient-oriented outcomes, such as neurologically intact survival. Few adverse events related to TEE have been documented. There is growing evidence that physicians can learn to use TEE during resuscitations and apply the findings to clinical decisions.
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Affiliation(s)
- Brian K Parker
- Department of Emergency Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Alexis Salerno
- Department of Emergency Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Brian D Euerle
- Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
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Abstract
The care for victims of out-of-hospital cardiac arrest is evolving and will be influenced by future and emerging technologies that will play a role in the systems of care for these patients. Recent advances in extracorporeal life support and point-of-care ultrasound imaging, both in-hospital and out-of-hospital, may offer a therapeutic solution in some systems for patients with refractory or recurrent cardiac arrest. Drones capable of delivering automated external defibrillators to the scene of an out-of-hospital cardiac arrest, advances in digital and mobile technologies to notify and leverage bystander response, and wearable life detection technologies may improve survival.
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Affiliation(s)
- Andrew J Latimer
- Department of Emergency Medicine, University of Washington, Box 359702, 325 Ninth Avenue, Seattle, WA 98104-2499, USA.
| | - Andrew M McCoy
- Department of Emergency Medicine, University of Washington, Box 359702, 325 Ninth Avenue, Seattle, WA 98104-2499, USA
| | - Michael R Sayre
- Department of Emergency Medicine, University of Washington, Box 359727, 325 Ninth Avenue, Seattle, WA 98104-2499, USA; Seattle Fire Department, Box 359702, 325 Ninth Avenue, Seattle, WA 98104-2499, USA
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