Emergency physician-performed transesophageal echocardiography for extracorporeal life support vascular cannula placement

James Fair; Joseph Tonna; Patrick Ockerse; Brian Galovic; Scott Youngquist; Stephen H McKellar; Michael Mallin

doi:10.1016/j.ajem.2016.06.038

Emergency physician-performed transesophageal echocardiography for extracorporeal life support vascular cannula placement

Am J Emerg Med. 2016 Aug;34(8):1637-9. doi: 10.1016/j.ajem.2016.06.038. Epub 2016 Jun 7.

Authors

James Fair¹, Joseph Tonna¹, Patrick Ockerse¹, Brian Galovic¹, Scott Youngquist¹, Stephen H McKellar¹, Michael Mallin¹

Affiliation

¹ Department of Surgery, University of Utah Hospital, Salt Lake City, Utah.

PMID: 27318746
DOI: 10.1016/j.ajem.2016.06.038

Abstract

Introduction: There is growing interest and application of extracorporeal membrane oxygenation (ECMO) as a life-saving procedure for out-of-hospital cardiac arrest (OHCA), also called extracorporeal life support (ECLS). Extracorporeal membrane oxygenation cannulation with ongoing chest compressions is challenging, and transesophageal echocardiography (TEE) is an invaluable tool with which to guide ECMO wire guidance and cannula positioning.

Methods: We describe our protocol for TEE guidance by emergency physicians in our hospital.

Results: Of our first 12 cases of ECLS, 10 have had TEE guidance by an emergency physician with successful placement and without complication or need for repositioning. Emergency physician-performed TEE for ECLS vascular cannula placement has been both feasible and useful in our experience and warrants further study.

MeSH terms

Catheterization / methods*
Echocardiography, Transesophageal / methods*
Education, Medical, Graduate / methods*
Extracorporeal Membrane Oxygenation / education*
Extracorporeal Membrane Oxygenation / methods*
Humans
Out-of-Hospital Cardiac Arrest / diagnosis
Out-of-Hospital Cardiac Arrest / therapy*
Physicians*