Duke Perioperative Echocardiography Service

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Echo Training During CT Fellowship

Goals

The following are the goals of the perioperative TEE education program:

To achieve advanced cognitive and technical skills in perioperative TEE as defined in the ASE/SCA training guidelines.
To complete at least 150 perioperative TEE exams that are personally performed, interpreted and reported.
To complete at least 150 complete TEE exams that are reviewed but not personally performed with supervising attendings.
To submit echo images for one case for publication in an imaging journal (example, Echo Rounds in Anesthesia & Analgesia).

In order to successfully ahieve these goals, fellows should seek the help of CT anesthesiology faculty, especially for goal #3. Faculty mentors can assist with identifying cases and preparation for publication. A manuscript relating to imaging should be submitted by the end of the fellowship.

Expectations:

Fellows should participate in all Wednesday morning TEE seminars that are designed to prepare them for the NBE board exams.
All TEE reports should be completed within 24 hours of the TEE exam.
Review TEE exams with echo reading attendings each weekduring their TEE rotation.
Complete a personal logbook of reviewed TEE cases.
Communicate all echo findings to the surgical team.

Rotations

During the TEE rotation, there will be a period of two weeks spent in the Cardiology Echo laboratory where fellows will learn the basics of ultrasound imaging, knobology of echo machines, standard chest wall imaging techniques and interpretation, involvement in stress echocardiography and daily didactic teaching activities with sonographers and cardiology faculty. Please contact Mike Foster

for more information.

There are dedicated weeks reserved for TEE in the operating room. Fellows are responsible for performing TEEs in all rooms with adult cardiac surgery cases. Attending anesthesiologists will provide instruction and guidance on image acquisition, optimization, interpretation and communication to the surgical team. All images are acquired and stored digitally on the hard drives for later transfer to the image server. Fellows then enter reports on a web-based form and hand off to the responsible attending physicians for e-signatures. Please use your assigned DHE user ID and password to log-in to the TEE web-based data entry site. There you can find video tutorials on how to enter data on this site.

For reviewing cases on the image server, use the Xcelera system available in the TEE reading room and on any Patient Information Network (PIN) station in the hospital. All fellows must attend an in service on using the Xcelera system with David Adams in the Duke Cardiac Diagnostic Unit. This will include information on how to extract video clips and still images from the image server while maintaining compliance with Duke Health System privacy rules.

Duke Perioperative Echo Protocol