Focussed Echocardiography examinations for the arrest / peri‐ arrest setting are limited, goal directed examinations performed to answer specific clinical questions. These examinations are not comprehensive and do not replace formal examinations performed in dedicated echocardiography units.
Views
- Subcostal, parasternal long axis, parasternal short axis, apical 4 chamber should be used to obtain the necessary information.
- It is recognised that in many patients, not all views will be of good quality. In addition, some echocardiographic windows may be inaccessible due to other factors such as contemporaneous procedures, such as Cardio‐Pulmonary Resuscitation (CPR).
Information to be obtained
- Is there a pericardial effusion, and if so, is there evidence of cardiac tamponade?
- Left ventricular size and systolic function.
- Right ventricular size and systolic function.
- Estimation of volume status.
Credentialing Requirements
- Completion of Accredited Course, ACEM Online module or Online Training Module (UTEC / ICN)
- Attend our ED Workshop or arranged 1-on-1 sessions with members of US-SIG.
- Candidates should perform 25 examinations. At least 5 of these should be clinically indicated (i.e. in the setting of cardiac arrest or haemodynamic compromise). These scans should be reviewed by a sonologist this may occur later using recorded images / loops). At least 5 of these examinations should be performed under the direct supervision of a sonologist.
- In addition, candidates should interpret a further 25 examinations, which have been performed either by themselves or by other practitioners (for example, previously recorded scans).
- These 50 cases must include at least two cases each of tamponade, right heart failure / massive PE, hypovolemia or distributive shock and left ventricular failure.
- Use this Echo worksheet to log your case and Here is a Sample Logbook.
Definition of Sonologist
A sonologist is used to include practitioners who have successfully completed this credentialing process or equivalent (e.g. CCPU, FEEL) or higher, more formal echocardiography training (such as PTEeXAM, ASCeXAM, PGDipEcho, PGCert / Dip of Clinical Ultrasound, DDU, DMU)
Resources
Online Training Module (UTEC / ICN)
Intensive Care Network Echocardiography Guide
Phillips Intro to Echocardiography Tutorial
peninsulapocus.com 