Rob Arntfield, MD, FRCPC and Atul Jaidka, MD, PGY2 takes us through the fundamentals of performing a transesophageal echocardiography (TEE). This video uses a live demonstration to introduce probe manipulation, how to obtain different views, and how to landmark for these different views. The techniques being presented will help you in performing goal-directed TEE in critically ill patients, whether it be for visualizing valvular [...]
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Critical Care Transesophageal Echocardiography (TEE) For most point-of-care needs, one can do both basic and more advanced applications of echocardiography with transthoracic scanning. However, there ARE times whereby having ability to perform transesophageal echocardiography (TEE) can be extremely helpful in the point-of-care. This is especially true when windows are hard to obtain in transthoracic echo (TTE) during a technically difficult study, or when a more sensitive and specific [...]
In this case a sudden deterioration in the emergency department prompts a TTE which shows some concerning physiology. It is not until the TEE is inserted, however, that the culprit disease can be identified. *Images courtesy of Dr. Drew Thompson, Division of EM, Western University https://www.youtube.com/watch?v=i8gAObUA-vY Case Highlights: *TEE in the ED is valuable for critically ill patients *TEE has advanced diagnostic potential, including the identification [...]
The transesophageal approach echocardiography has numerous advantages for those providing resuscitation to the critically ill, including those with cardiac arrest. While the transthoracic approach is often quite useful, quality images in ventilated patients are more challenging. Thus, the reliable, high quality image acquisition of TEE is very attractive for the resus room. It is, however, the continuous nature of TEE - due to the probe [...]
The point of care, critical care ultrasound (CCUS) program at Western University has become enabled with transesophageal echo (TEE) capability. The arrival of new TEE transducers that function on the bedside, point of care machines in all our ICU’s will allow for expanded capabilities in properly trained hands. With several Critical Care Western program faculty (as well as some fellows) being trained in TEE use, [...]
Hi POCUS enthusiasts, We set a new record with >65 participants in last week's case voting. Unfortunately this will be our last COTW/COTG until we are back in action in early April. For all those who haven't signed up for automatic distribution do it now by going to westernsono.ca and filling in your name and email address. This will be the last email reminder! Now let's jump into [...]
Hi POCUS enthusiasts,Thanks again to the more than 20 participants in the online voting for last week's case! For those who have yet to sign up, just go to westernsono.ca and insert your name and email into the text box on the right side of the webpage. Then get ready to flex your POCUS muscles and post your answers/votes. Or click here to access the case directly: https://westernsono.ca/category/cases/ The [...]
A 42 year old female is admitted with ARDS and a pleural POCUS is performed. Due to difficulties identifying lung sliding, M-mode was used to evaluate for pneumothorax. Based on this image, does the patient has a pneumothorax? What is the 2D ultrasound image correlate of the vertical areas as shown by the arrows?
Hi POCUS people, I hope you all enjoyed a lovely Remembrance Day weekend. Here in London we got our first sprinkling of snow, which was highly exciting for this Vancouverite. Bring on the holiday season! The Case This case comes to us from Dr Heather Hames from our fantastic ED POCUS contingent. This was an elderly gentleman who presented with weakness, falls, and [...]
Morning POCUS pals, Hope you're all gearing up to enjoy some serious hocus-pocus this Hallowe'en! The Case This was a 70-something gentleman who was received in the ICU after an intra-operative arrest during an orthopedic surgery for a hip fracture with an intramedullary hip screw. Given that clinical context, and the clips below, what might have occurred to cause his arrest? [...]