Is 1 Day of Focused Training in Echocardiographic Assessment Using Subxiphoid-Only (EASy) Examination Enough? A Tertiary Hospital Response to the COVID-19 Crisis and the Use of the EASy Examination to Support Unit-Wide Image Acquisition

Overview

Journal Crit Care Explor

Specialty Critical Care

Date 2024 Feb 28

PMID 38415022

Authors

Nibras F Bughrara

Maegan R Neilson

Stephanie Jones

Lorna Workman

Amit Chopra

Aliaksei Pustavoitau

Affiliations

Soon will be listed here.

Abstract

Objectives: We assessed the efficacy of 1-day training in echocardiography assessment using subxiphoid-only (EASy) followed by supervised image interpretation and decision-making during patient rounds as a novel approach to scaling up the use of point-of-care ultrasound (POCUS) in critically ill patients.

Design: Retrospective analysis of medical records and EASy examination images.

Setting: Tertiary care academic hospital.

Patients: A total of 14 adults (> 18 yr old) with COVID-19-associated respiratory failure under the care of Albany Medical Center's surge response team from April 6-17, 2020 who received at least one EASy examination.

Interventions: Residents (previously novice sonographers) were trained in EASy examination using 1 day of didactic and hands-on training, followed by independent image acquisition and supervised image interpretation, identification of hemodynamic patterns, and clinical decision-making facilitated by an echocardiography-certified physician during daily rounds.

Measurements And Main Results: We recorded the quality of resident-obtained EASy images, scanning time, and frequency with which the supervising physician had to repeat the examination or obtain additional images. A total of 63 EASy examinations were performed; average scanning time was 4.3 minutes. Resident-obtained images were sufficient for clinical decision-making on 55 occasions (87%), in the remaining 8 (13%) the supervising physician obtained further images.

Conclusions: EASy examination is an efficient, valuable tool under conditions of scarce resources. The educational model of 1-day training followed by supervised image interpretation and decision-making allows rapid expansion of the pool of sonographers and implementation of bedside echocardiography into routine ICU patient management.

Citing Articles

Mistaken Identity: Misidentification of Other Vascular Structures as the Inferior Vena Cava and How to Avoid It.

Zimmerman J, Morrissey C, Bughrara N, Bronshteyn Y Diagnostics (Basel). 2024; 14(19).

PMID: 39410622 PMC: 11476350. DOI: 10.3390/diagnostics14192218.

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