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The Ultrasound Journal
Published in: The Ultrasound Journal 1/2015

Open Access 01-12-2015 | Original Article

Focused transesophageal echocardiography for emergency physicians—description and results from simulation training of a structured four-view examination

Authors: Robert Arntfield, Jacob Pace, Shelley McLeod, Jeff Granton, Ahmed Hegazy, Lorelei Lingard

Published in: The Ultrasound Journal | Issue 1/2015

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Abstract

Background

Transesophageal echocardiography (TEE) offers several advantages over transthoracic echocardiography (TTE). Despite these advantages, use of TEE by emergency physicians (EPs) remains rare, as no focused TEE protocol for emergency department (ED) use has been defined nor have methods of training been described.

Objective

This study aims to develop a focused TEE examination tailored for the ED and to evaluate TEE skill acquisition and retention by TEE-naïve EPs following a focused 4-h curriculum.

Methods

Academic EPs were invited to participate in a 4-h didactic and simulation-based workshop. The seminar emphasized TEE principles and views obtained from four vantage points. Following the training, participants engaged in an assessment of their abilities to carry out a focused TEE on a high-fidelity simulator. A 6-week follow-up session assessed skill retention.

Results

Fourteen EPs participated in this study. Immediately following the seminar, 14 (100 %; k = 1.0) and 10 (71.4 %, k = 0.65) successfully obtained an acceptable mid-esophageal four-chamber and mid-esophageal long-axis view. Eleven (78.6 %, k = 1.0) participants were able to successfully obtain an acceptable transgastric short-axis view, and 11 (78.6 %, k = 1.0) EPs successfully obtained a bicaval view. Twelve participants engaged in a 6-week retention assessment, which revealed acceptable images and inter-rater agreement as follows: mid-esophageal four-chamber, 12 (100 %; k = 0.92); mid-esophageal long axis, 12 (100 %, k = 0.67); transgastric short-axis, 11 (91.7 %, k = 1.0); and bicaval view, 11 (91.7 %, k = 1.0).

Conclusion

This study has illustrated that EPs can successfully perform this focused TEE protocol after a 4-h workshop with retention of these skills at 6 weeks.
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Metadata
Title
Focused transesophageal echocardiography for emergency physicians—description and results from simulation training of a structured four-view examination
Authors
Robert Arntfield
Jacob Pace
Shelley McLeod
Jeff Granton
Ahmed Hegazy
Lorelei Lingard
Publication date
01-12-2015
Publisher
Springer Milan
Published in
The Ultrasound Journal / Issue 1/2015
Electronic ISSN: 2524-8987
DOI
https://doi.org/10.1186/s13089-015-0027-3

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