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, [...]
Happy Monday A-line Aficionados, The best week of the year is finally here, CRUS week! It's time to see old friends, share some laughs and rediscover the pleasure of finding the costodiaphragmatic angle in healthy volunteers. But for now, lube up it's COTW time! The Case Our COTW case comes from ED POCUS Pro Pedagogue Drew Thompson. It features a young gentleman with testicular cancer and a history of [...]
Transesophageal Echocardiography: Image Acquisition 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 [...]
The Case: A 62M patient with ascites requires paracentesis. POCUS is performed to help landmark. What do you think of these images? Is there ascites present? Is this a safe location to perform paracentesis? If not, why not? COTG: A patient post MVC with C-spine injury and tracheostomy. Here are an M-mode image and 2D clip of the diaphragm while on trach [...]
The COTW: A young male with a collagen-vascular disorder presents with shock. Here is one view from his POCUS, what do you think? Leave a comment below! Answer from Last week: This young man has a very broken looking heart, and it wasn't because his true love crushed him on Valentine's day - he has a dilated cardiomyopathy. Vince Lau, our POCUS alumnus and echo-aficionado [...]
Medical Student Ultrasound Symposium 2015 Western Student Ultrasound Symposium 2OCT Once again, students from across Canada came to London’s own CSTAR facility for the 3rd Annual Western Student Ultrasound Symposium. Focusing on basic principles and techniques of Point-of-Care Ultrasound, the Western Student Ultrasound Symposium strives to provide medical students with exposure and training with beside ultrasound. The highlight of the weekend was once again [...]