Photo Credit: faustasyan
The following is a summary of “Simulation-Based Resuscitative Transesophageal Echocardiography Training for Emergency Medicine Residents,” published in the November 2024 issue of Emergency Medicine by Fried et al.
Transesophageal echocardiography (TEE) is a growing resuscitation tool in emergency medicine (EM), and simulation-based training is essential for teaching this skill, though its effectiveness in preparing residents for live patient scenarios has not been evaluated.
Researchers conducted a retrospective study to evaluate competency after simulation training and the performance of live patients on resuscitative TEE in the operating room (OR).
They enrolled volunteer PGY2 and PGY3 EM residents. Participants completed a pre-test on general TEE knowledge, followed by a 30-minute lecture on a resuscitative protocol covering mid-esophageal four chamber (ME4C), mid-esophageal long axis (MELAX), trans-gastric short axis (TGSAX), and ascending aortic short axis (AscAoSAX). Residents then participated in 2, 1-hour HeartWorks TEE simulator sessions guided by a physician trained in resuscitative TEE. Afterward, a post-test was administered, followed by a TEE examination in the OR with a cardiac anesthesiologist. Data were summarized using descriptive statistics, and test scores were compared using paired t-tests or Wilcoxon rank-sum tests.
The results showed that 15 residents participated, with a pre-test mean score of 11.07 (95% CI: 9.35 – 12.79) and a post-test mean score of 19.40 (95% CI: 18.94 – 19.86). A significant difference was observed between the pre-and post-test scores, t = -11.996, P < 0.0001. In the OR assessment, the mean number of placement attempts was 1.27 (95% CI: 1.01 – 1.52). Clinically acceptable views were obtained in 93.3% for ME4C and MELAX, 60% for AscAoSAX and TGSAX, of the 60 total views, 76.7% were deemed acceptable.
Investigators concluded that simulation-based training in resuscitative TEE effectively prepares EM residents to acquire and interpret TEE images.
Source: jem-journal.com/article/S0736-4679(24)00356-1/abstract
