Transoesophageal Echocardiography

Details

Title

Transoesophageal Echocardiography

Type

Stage Two

Module code

HPS146

Requirement

Optional

Module objective

By the end of this module the Clinical Scientist in HSST, with respect to transoesophageal echocardiography, will be able to critically analyse, synthesise, evaluate and apply knowledge, perform and interpret transoesophageal echocardiograms and be able to take a leadership role in a TOE service, including the quality assurance and training of other staff, while demonstrating the attitudes and behaviours necessary for the role of a Consultant Clinical Scientist working in a patient-focused service.

Knowledge and understanding

By the end of this module the Clinical Scientist in HSST will critically analyse, synthesise, evaluate and apply their expert knowledge of transoesophageal echocardiography, including:

• indications, contraindications and limitations of TOE;
• principle of disinfection, probe maintenance and storage;
• principles of assessment of anaesthetic risk;
• TOE views, image planes and echo-anatomic correlations;
• the effects of anaesthesia and cardiopulmonary bypass on the heart;
• the principles and techniques of 3D transoesophageal echocardiography;
• national and international recommendations and guidelines for the following: (i) indications for echocardiography; (ii) standards for performing and reporting of echocardiograms; (iii) institutional accreditation for echocardiography departments; (iv) the roles of clinical and technical leadership in echocardiography departments; (v) training and supervision;
• current research and emerging advances.

Technical and clinical skills

By the end of this module the Clinical Scientist in HSST will be able to demonstrate a critical understanding of current research and its application to the performance, adaptation and mastery of a range of clinical and communication skills and will:

• assess anaesthetic risk and plan and monitor the procedure appropriately;
• perform a complete, comprehensive transoesophageal echocardiogram in conscious sedated or anaesthetised adult patients;
• interpret, measure and analyse a transoesophageal echocardiogram in an adult and produce a comprehensive echocardiogram report;
• assess complex heart valve disease, including severity, suitability for repair/percutaneous procedures and assess valve disease post- procedure;
• assess acute aortic syndromes (dissection, intramural haematoma);
• use TOE in the investigation of stroke or embolic events, including detection of patent foramen ovale, intracardiac thrombus, tumour;
• detect and assess simple congenital heart defects, e.g. atrial septal defect (ASD) (including sinus venous defects);
• perform TOE in the critical care setting, to assess ventricular function, filling and inotropic status;
• perform TOE during percutaneous cardiac interventional procedures, e.g. patent foramen ovale (PFO) closure, percutaneous valve intervention and assess valve disease post-procedure;assess anaesthetic risk and plan and monitor the procedure appropriately;
• perform perioperative TOE during cardiac surgery, assess efficacy of valve repair, identify perioperative complications, interpretation of findings in the setting of cardiopulmonary bypass.

Attitudes and behaviours

By the end of this module the Clinical Scientist in HSST will be expected to critically evaluate their own response to both normal and complex situations, consistently demonstrating the professional attributes and insights required of a Clinical Scientist in HSST working within the limits of professional competence, referring as appropriate to senior staff, and will:

• adequately explain the procedure to the patient and maintain trust;
• explain the results adequately;
• work with echocardiographers, cardiac surgeons, anaesthetists and interventional cardiologists;
• integrate the results of TOE with the clinical context to produce recommendations;
• collaborate with specialists in other imaging modalities;
• critically reflect on your clinical practice;
• audit results;
• adopt leadership roles in organisation and administration;
• develop leadership skills in training and clinical supervision;work with echocardiographers, cardiac surgeons, anaesthetists and interventional cardiologists;
• work collaboratively with cardiologists, cardiac surgeons, other medical staff, healthcare science practitioners, echocardiographers and nurses.