TEE Async. Flashcards
What kind of procedure is TEE?
Invasive
What does TEE require in terms of skill?
Expertise, Non-invasive cardiologists are trained in this
What does TEE need from the patient?
- Cooperation
- Preparation
Where is the Ultrasound traducer on the TEE?
Gastroscope
Images are from where in the chest cavity?
Behind/ under the heart
What are some advantages of TEE?
- Proximity to heart
- No lung and ribs
- Somewhat non-invasive compared to OHS
- Somewhat portable
- Improves imaging for technically difficult patients
- Visualization of posterior structures
What are some disadvantages of TEE?
- Somewhat invasive
- Expertise required
- Patient discomfort
- Complications
- Operator dependent
What is TEE patient preparation?
- Procedure explained
- Patient history taken
- Ensure fasting (patient may vomit during gag reflux)
- Physical
What is the physical portion of TEE patient prep?
- IV started - easier administrations of medications
- Removal of dentures
- Set up ECG
- Set up blood pressure and pulse oximeters
What should be done for patient care during TEE?
- Vitals (O2 and BP)
- Instruction to patient (breathing and swallowing)
- Post examination process
What is included in the patient post examination care?
- Looking for esophageal damage
- Tooth damage
- Blood pressure dropping
What are some indications for TEE?
- Source of embolus
- Valvular disease
- Abnormal LV
- Masses
- Prosthetic devices
- Interoperative
- Aortic disease
- Non-diagnostic TTE
- CHD
What are 4 absolute contraindications for TEE?
- Esophageal strictures, masses, perforations
- Recent bleed or surgery
- Poorly cooperative patient
- Severe respiratory depression
What are some relative contraindications (with caution)?
- Coagulopathy issues
- Restricted cervical mobility
- Recent esophageal trauma/ radiation
- Esophageal varices
- Dysphagia (trouble swallowing)
- Sleep apnea
What are some TEE complications?
- Dental trauma
- Esophageal truama/ bleeding/ perforation
- Laryngospasm or bronchospasm
- **Aspiration
- Dislodgement of endotracheal/ nasogastric tubes
- Sore throat, hoarseness
What are some complications of TEE with the technologist?
- Combative patient under sedation
- Bites
- cleaning
- Vomit
- Equipment damage
What are 5 TEE probe manipulations?
- Advance/ withdraw
- Flexion
- Extension
- Rotation
- Side to side
What are three TEE probe positions?
- Transgastric
- Mid esophageal
- Upper esophageal
Label
What is the most superior TEE view?
Upper esophageal
What are some structures seen with UE view?
- Aorta
- Ao valve
- Superior IAS
- LA appendage
Where is most of the TEE exam done?
Mid esophageal because it is similar to AP4 in TTE
What is seen with ME TEE?
- The MV/TV valves
- IAS
- IVS
- LA appendage
- Almost all structures except LV apex
What is seen with transgastric view?
- Apical structures up to the AV valves
- Especially LV apex
- Apical IVS
Label
What is the Upper esophageal TEE view good for?
Looking at aorta and surrounding structures
What chamber is closest to the probe with ME view?
LA
Label
What is the TG view?
The probe is advanced further down the esophagus into the stomach
What does TG view allow? What view is the closest to the probe?
- Allows us to see more inferior heart structures
- Posterior wall
What is TEE GE good for?
Evaluation of
1. LV
2. MV
3. Muscular IVS
