Emergency physician-performed transesophageal

Am J Emerg Med · Aug 2016

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

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. ⋯ 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.

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- James Fair, Joseph Tonna, Patrick Ockerse, Brian Galovic, Scott Youngquist, Stephen H McKellar, and Michael Mallin.
- Department of Surgery, University of Utah Hospital, Salt Lake City, Utah.
- Am J Emerg Med. 2016 Aug 1; 34 (8): 1637-9.
IntroductionThere 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.MethodsWe describe our protocol for TEE guidance by emergency physicians in our hospital.ResultsOf 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.Copyright © 2016 Elsevier Inc. All rights reserved.

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

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