Transesophageal Echocardiography (TEE) in Cardiac Arrest

• Inspired by Dr. Patrick Ockerse gave a phenomenal lecture at the Yellowstone Ultrasound Conference in Jackson Hole last May
• There are lots of benefits to using TEE during cardiac arrest
• Evaluate actual cardiac function as opposed to less reliable markers of cardiac function
• Is the rhythm actually asystole? If not, should you do chest compressions? If yes, can that help prognosticate?
• Evaluate quality of chest compressions
• Ability to cardiovert with probe in place
• Minimize time off the chest to assess for cardiac function
• Check for the H&T’s for example tamponade or right heart strain suggesting PE
• Significantly improved image quality as compared to TTE
• You don’t need to be perfect, you just need to get a view of the heart
• Some downsides to TEE
• Lack of experience with TEE and mental road blocks to utilizing the technology
• The patient must be intubated
• TEE probes are expensive
• Are you still interested and want to learn more about TEE? Check out this and this 

Resources:

• Blaivas M: Transesophageal echocardiography during cardiopulmonary arrest in the emergency department. Resuscitation 2008; 78:135 – 140.
• Vignon, Philippe, Tobias M. Merz, and Antoine Vieillard-Baron. "Ten reasons for performing hemodynamic monitoring using transesophageal echocardiography." Intensive Care Medicine (2017): 1-4.
• http://www.scancrit.com/2015/03/03/tee-cardiac-arrest/