click below
click below
Normal Size Small Size show me how
TEE
ANP1 Exam 3
Question | Answer |
---|---|
how does TEE work | 1. sound waves penetrate tissue to creat 2-3 dimensional images 2. doppler echo uses US scatter from blood cells to measure velocity/direction of blood flow |
when is TEE probe inserted | after pt anesthetized, ETT secured, OG inserted for decompression of stomach contents |
how is TEE inserted | 1. mandible displaced anteriorly 2. probe placed into midline post. pharynx 3. inserted into esophagus 4. laryngoscope may be used to displace mandible and beter visualize esoph. opening |
when does heart come into view | probe is in thoracic esophagus ~ 30 cm |
TEE pt hx contraindications | 1. dysphagia 2. odynophagia (painful swallowing) 3. mediastinal radation 4. recent upper GI surg or bleeding |
TEE esophageal pathology contraindications | 1. stricture 2. tumor 3. diverticulum 4. varices 5. esophagitis 6. recent chest trauma |
TEE complications | 1. dental/oral trauma 2. laryngeal dysfx leading to post op aspiration 3. ETT displacement (R mainstem) 4. upper GI bleeding 5. pharyngeal/esophageal perf (rare) |
TEE assessment | 1. **regional wall motion abnormalities - most sensitive indicator for cardiac event 2. SV (EF) 3. valve fx 4. intracardiac air 5. effects of AA/surg on cardiac fx 6. adequacy of IV volume 7. eschemic episode 4x more than ECG |
ASA TEE categories | Category 1 - strongest evidence TEE is helpful 1. *valve repair 2. *congenital heart defects 3. hypertrophic obstructive CM 4. aortic dissection 5. *infective endocarditis 6. unstable, life threatening hemodynamics |