emDocs - August 2, 2018- Written by: Montrief T, Scott J, and Alerhand S
Edited By: Singh M and Koyfman A
"Pearls and Pitfalls
- TEE provides high-resolution images continually throughout resuscitation without causing prolonged interruptions in chest compressions, and is not distorted by the patient’s body habitus, defibrillator pads, subcutaneous air, or lung disease.
- TEE is an invaluable tool in the investigation and treatment of reversible causes of cardiac arrest including myocardial infarction, pulmonary embolism, pericardial tamponade, tension pneumothorax, and hypovolemia.
- Complications of TEE are rare, but include pharyngeal and esophageal laceration, hematoma, or esophageal perforation.
- The most common and useful TEE views include the midesophageal four chamber, midesophageal long axis, transgastric short axis, and bicaval views, which are analogous to common TTE views (apical four chamber, parasternal long axis, parasternal short axis, and subcostal IVC, respectively).
- ACEP has provided a clinical policy recommending the following for competency standards: 1) minimum of 2–4 hours of TEE specific training or education, 2) performing at least 10 proctored TEE examinations in live patients and simulation models, and 3) completion of a standardized assessment by a credentialed TEE provider."