Abstract
Background
Transesophageal echocardiography (TEE) has been shown to be a powerful tool that emergency
physicians can use to guide resuscitation efforts during cardiac arrest. Currently,
there is no standardized curriculum to teach TEE to emergency physicians.
Objective
We hypothesized that the use of a pilot training course combining interactive e-learning
and hands-on simulation would increase the percentage of students achieving a score
of ≥80% on a multiple-choice test of knowledge and increase self-reported comfort
using TEE.
Methods
We designed a 2.5-h TEE course for emergency physicians and medical intensive care
unit fellows. Participants took a test of knowledge and a survey of comfort—both online—before,
just after, and 4 weeks after taking the course. Survey responses measured participants
self-reported comfort with using TEE in clinical practice. A normal binomial approximation
was used to calculate the 95% confidence interval.
Results
Of the 3 tests of knowledge, 15 participants completed all tests. Of the surveys of
comfort, 31 participants completed the precourse survey, 32 completed the postcourse
survey, and 19 completed the 4-week follow-up survey. The proportion of students scoring
≥80% improved from 40% on the precourse test to 80% on the postcourse test (95% confidence
interval 1–79). The proportion of students indicating comfort with using TEE improved
from 3% precourse to 53% postcourse (95% confidence interval 28–71).
Conclusions
A TEE training course resulted in a 50% increase in surveyed participants feeling
comfortable using TEE in cardiac arrest and a 40% increase in participants scoring
≥80% on a test of knowledge.
Keywords
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References
- Heart Disease and Stroke Statistics-2018 Update: a report from the American Heart Association.Circulation. 2018; 137: e67-e492
- Ultrasound use during cardiopulmonary resuscitation is associated with delays in chest compressions.Resuscitation. 2017; 119: 95-98
- Diagnostic accuracy of transesophageal echocardiography during cardiopulmonary resuscitation.J Am Coll Cardiol. 1997; 30: 780-783
- Transesophageal echocardiography during cardiopulmonary arrest in the emergency department.Resuscitation. 2008; 78: 135-140
- Emergency physician-performed transesophageal echocardiography for extracorporeal life support vascular cannula placement.Am J Emerg Med. 2016; 34: 1637-1639
- The use of transesophageal echocardiography during cardiac arrest resuscitation: a literature review.J Ultrasound Med. 2019; 38: 1141-1151
- Focused transesophageal echocardiography for emergency physicians: description and results from simulation training of a structured four-view examination.Crit Ultrasound J. 2015; 7: 27
- Transesophageal echocardiography during cardiopulmonary resuscitation is associated with shorter compression pauses compared with transthoracic echocardiography.Ann Emerg Med. 2019; 73: 610-661
- Guidelines for the use of transesophageal echocardiography (TEE) in the ED for cardiac arrest.Ann Emerg Med. 2017; 70: 442-445
Article info
Publication history
Published online: April 30, 2020
Accepted:
March 23,
2020
Received in revised form:
March 20,
2020
Received:
November 30,
2019
Footnotes
Reprints are not available from the authors.
Identification
Copyright
Published by Elsevier Inc.
