TEE Async.

Question 1

What kind of procedure is TEE?

Answer 1

Invasive

Question 2

What does TEE require in terms of skill?

Answer 2

Expertise, Non-invasive cardiologists are trained in this

Question 3

What does TEE need from the patient?

Answer 3

1. Cooperation
2. Preparation

Question 4

Where is the Ultrasound traducer on the TEE?

Answer 4

Gastroscope

Question 5

Images are from where in the chest cavity?

Answer 5

Behind/ under the heart

Question 6

What are some advantages of TEE?

Answer 6

1. Proximity to heart
2. No lung and ribs
3. Somewhat non-invasive compared to OHS
4. Somewhat portable
5. Improves imaging for technically difficult patients
6. Visualization of posterior structures

Question 7

What are some disadvantages of TEE?

Answer 7

1. Somewhat invasive
2. Expertise required
3. Patient discomfort
4. Complications
5. Operator dependent

Question 8

What is TEE patient preparation?

Answer 8

1. Procedure explained
2. Patient history taken
3. Ensure fasting (patient may vomit during gag reflux)
4. Physical

Question 9

What is the physical portion of TEE patient prep?

Answer 9

1. IV started - easier administrations of medications
2. Removal of dentures
3. Set up ECG
4. Set up blood pressure and pulse oximeters

Question 10

What should be done for patient care during TEE? 3

Answer 10

1. Vitals (O2 and BP)
2. Instruction to patient (breathing and swallowing)
3. Post examination process

Question 11

What is included in the patient post examination care? 3

Answer 11

1. Looking for esophageal damage
2. Tooth damage
3. Blood pressure dropping

Question 12

What are some indications for TEE?

Answer 12

1. Source of embolus
2. Valvular disease
3. Abnormal LV
4. Masses
5. Prosthetic devices
6. Interoperative
7. Aortic disease
8. Non-diagnostic TTE
9. CHD

Question 13

What are 4 absolute contraindications for TEE?

Answer 13

1. Esophageal strictures, masses, perforations
2. Recent bleed or surgery
3. Poorly cooperative patient
4. Severe respiratory depression

Question 14

What are some relative contraindications (with caution)?

Answer 14

1. Coagulopathy issues
2. Restricted cervical mobility
3. Recent esophageal trauma/ radiation
4. Esophageal varices
5. Dysphagia (trouble swallowing)
6. Sleep apnea

Question 15

What are some TEE complications?

Answer 15

1. Dental trauma
2. Esophageal truama/ bleeding/ perforation
3. Laryngospasm or bronchospasm
4. **Aspiration
5. Dislodgement of endotracheal/ nasogastric tubes
6. Sore throat, hoarseness

Question 16

What are some complications of TEE with the technologist?

Answer 16

1. Combative patient under sedation
2. Bites
3. cleaning
4. Vomit
5. Equipment damage

Question 17

What are 5 TEE probe manipulations?

Answer 17

1. Advance/ withdraw
2. Flexion
3. Extension
4. Rotation
5. Side to side

Question 18

What are three TEE probe positions?

Answer 18

1. Transgastric
2. Mid esophageal
3. Upper esophageal

Question 19

Label

Answer 19

Question 20

What is the most superior TEE view?

Answer 20

Upper esophageal

Question 21

What are some structures seen with UE view? 4

Answer 21

1. Aorta
2. Ao valve
3. Superior IAS
4. LA appendage

Question 22

Where is most of the TEE exam done?

Answer 22

Mid esophageal because it is similar to AP4 in TTE

Question 23

What is seen with ME TEE?

Answer 23

1. The MV/TV valves
2. IAS
3. IVS
4. LA appendage
5. Almost all structures except LV apex

Question 24

What is seen with transgastric view?

Answer 24

1. Apical structures up to the AV valves
2. Especially LV apex
3. Apical IVS

Question 25

Label

Answer 25

Question 26

What is the Upper esophageal TEE view good for?

Answer 26

Looking at aorta and surrounding structures

Question 27

What chamber is closest to the probe with ME view?

Answer 27

LA

Question 28

Label

Answer 28

Question 29

What is the TG view?

Answer 29

The probe is advanced further down the esophagus into the stomach

Question 30

What does TG view allow? What view is the closest to the probe?

Answer 30

1. Allows us to see more inferior heart structures 2. Posterior wall

Question 31

What is TEE GE good for?

Answer 31

Evaluation of 1. LV 2. MV 3. Muscular IVS