Intra-arrest transesophageal echocardiography: A retrospective analysis

Claire in surgery room holding ECG tool

Students

2020
College

Faculty

Associate Professor of Emergency Medicine

Project Summary

​​​​​This summer I participated in two projects while working with Dr. Felipe Teran under the mentorship of Dr. Ben Abella. Firstly, I extracted data from patient charts who had undergone transesophageal echocardiography (TEE) at point-of-care in the HUP Emergency Department (ED). Most of these cases involved the use of TEE during cardiac arrest to help determine etiology of arrest or analyze cardiac function. Along with extracting all the data, I also came in to the ED for every arrest that TEE was going to performed in order to take notes and help set up the process. The overall goal of this project is to improve how cardiac arrest is treated in the ED with the use of TEE. Through this project I learned more about ED operations, clinical information regarding the use of TEE, how to use the software REDCap, and operate the charting system EPIC.

The second project I worked on involved me driving up to Dartmouth. Dr. Teran received a grant from the Zoll foundation to do resuscitation research in pigs. We studied the effect of CPR on a pulseless electrical activity (PEA) model of arrest. This was induced through gradually reducing the percentage of oxygen the pigs were breathing from room air to about 6% oxygen. We defined PEA as 30 seconds of a systolic blood pressure between 40 and 30 mmHg. The pig would either get CPR and epinephrine (intervention) or just epinephrine (control). The goal of this study is to demonstrate CPR is still needed in a PEA arrest as well as study hemodynamic data in this type of arrest. We also performed TEE on the pigs. I was in charge of keeping track of the timing of the protocol, checking the epinephrine doses, recording notes and outcomes, and helping with any procedures while preparing the pig for the experiment.

I learned so much from participating in these projects. I gained a lot of clinical experience which is invaluable in my pursuit to become a doctor. I learned the basics of research techniques and how animal research with swine is conducted. I look forward to continuing to work with Dr. Teran and Dr. Abella in resuscitation science.