Dr. Ross Prager, Resus-TEE expert, discusses the benefits of Resuscitative Transesophageal Echocardiography in critical care, covering its role in assessing heart conditions, cardiac arrest, shock, trauma, and procedural guidance. The chapter also explores the risks and logistics of implementing Resus-TEE, setting up a ResusTE program, and medical legal considerations for Point of Care Ultrasound.
Transesophageal Echocardiography assists in phenotyping shock, diagnosing heart failure, and guiding therapy.
TEE offers advantages like quick high-quality images, repeated assessments, and real-time reassessments during resuscitation.
TEE is a game-changer in cardiac arrest, trauma resuscitation, and critical situations, enhancing decision-making and patient outcomes.
Deep dives
TE: an Invaluable Tool for Critical Care
Transisophageal Echocardiography (TE) emerges as a crucial tool for phenotyping shock in critical care. Its ability to quickly provide high-quality images assists in diagnosing RV and LV failure, guiding therapy with precision. TE allows diverse providers to address focus questions tailored to the patient's condition, making it valuable in assessing critically ill patients.
Advantages of TE Over Point of Care Ultrasound
TE offers advantages over traditional point-of-care ultrasound by providing near-perfect views within seconds, facilitating repeated assessments during resuscitation. Its ability to overcome challenges like physical constraints during imaging, and to offer repeatable and real-time reassessments, makes TE a valuable tool for managing critically ill patients.
Clinical Applications of TE: Cardiac Arrest and Shock
In clinical scenarios like cardiac arrest and undifferentiated shock, TE proves to be a game-changer, aiding in identifying the arrest's etiology, optimizing CPR placement, and guiding procedural interventions. TE's ability to provide real-time physiological and anatomical insights during critical situations enhances decision-making and improves patient outcomes.
TE in Trauma and Novel Hemodynamic Evaluations
In trauma settings, TE reveals valuable insights such as dynamic LVOT obstructions and hemodynamic phenotypes, challenging traditional assumptions about traumatic shock classification. Its role in aiding rapid diagnosis and management decisions showcases TE's potential to impact trauma resuscitation outcomes.
Future of TE in Critical Care and Medical-Legal Insights
The future of TE looks promising with collaborative efforts like the Resuscitative TE project paving the way for extensive research on its applications and outcomes. Medical-legal analyses highlight the importance of integrating TE appropriately and ensuring documentation accuracy to enhance patient care and mitigate legal risks in the clinical setting.
On Critical Care Time we are - of course - HUGE fans of POCUS. On this episode, Nick and Cyrus take this love for POCUS to the next level with our discussion on Resuscitative Transesophageal Echocardiography (Resus-TEE) with Canadian intensivist, Dr. Ross Prager (@ross_prager), Resus-TEE expert aficionado! On this show, we discuss the basics of Resus-TEE including indications, pitfalls and pearls, the practicality of implementing this modality at your hospital and some of the medico-legal considerations. We had a ton of fun recording this with Ross and hope you enjoy listening to it!