2025 FSA Podium and Poster Abstracts

Introduction: Rescue Transesophageal Echocardiography (TEE) is an essential diagnostic tool in the perioperative and critical care settings when anesthesiologists are confronted with non-differentiated hemodynamic instability. Despite its significance, formal training in rescue TEE remains limited in many anesthesiology residency programs, with most programs focusing primarily on its applications in cardiac anesthesiology. This structured, three-session curriculum provides a standardized approach to developing TEE proficiency among anesthesiology residents with a focus on its use outside of the CVOR.

Discussion: This curriculum is designed to build residents’ competency in rescue TEE through three separate didactic sessions consisting of lectures, hands on workshops and a scored assessment. The first session, Foundations of Rescue TEE, introduces the indications, contraindications, and technical aspects of TEE, with a focus on probe handling and the acquisition of standard views. The second session, Image Acquisition and Interpretation, emphasizes the recognition of normal and pathological cardiac findings, including hypovolemia, tamponade, right and left ventricular dysfunction, and valvular abnormalities. The final session, Clinical Integration and Decision-Making, focuses on clinical applications of these skills, with residents being given clinical examples of multiple pathologies and assessed on their ability to correctly identify them.

This structured training program aligns with competency-based medical education principles by incorporating progressive skill development, formative feedback, and summative assessment. The use of simulation-based learning enhances the resident experience by allowing for deliberate practice in a controlled environment, improving retention and confidence before applying skills in real patient care – particularly in procedural specialites. Furthermore, the emphasis on case-based discussions and clinical integration ensures that residents can translate TEE findings into actionable decisions, optimizing patient outcomes in critical situations.

Implementing a rescue TEE curriculum within an anesthesiology residency program has several key benefits. First, it is a skillset that every anesthesiologist can use outside of the CVOR. Second, it enhances interdisciplinary collaboration, as anesthesiologists trained in rescue TEE can effectively communicate findings with the surgical team, intensivists, and cardiologists. Third, it aligns with emerging accreditation requirements from the ABA emphasizing competency in perioperative ultrasound and echocardiography, preparing residents for the APPLIED exam and future practice.

Conclusion: In conclusion, incorporating a structured rescue TEE curriculum into anesthesiology residency training enhances clinical decision-making, improves patient safety, and addresses a critical educational gap in perioperative and critical care medicine. By providing residents with the tools to acquire, interpret, and apply rescue TEE findings effectively, this curriculum strengthens their ability to manage the unstable patient. The implementation of this program can significantly enhance the quality of anesthesia training, ultimately leading to better patient outcomes and more confident, well-rounded anesthesiologists.