DK2985_C000 1..28 - AlSharqia Echo Club

7Equipment, Complications, Infection Control, and SafetyGENEVIÈVE CÔTÉ, ANDRÉ Y. DENAULTUniversity of Montreal, Montreal, CanadaI. Introduction 141II. Biological Effects 141A. Thermal Bioeffect 142B. Thermal Safety 143C. Cavitation 143D. Intensity Measurement andQuantification 144E. Electrical Safety 144III. Personnel and Equipment 144IV. Patient Evaluation Beforethe Procedure 144A. Indications 144B. Evaluation 145C. Contraindications 146V. Prophylaxis Planification 146VI. Monitoring and Patient Position DuringTEE Examination 147VII. TEE Probe Inspection 147VIII. Esophageal Intubation 149IX. Complications of TEE 151X. Probe Maintenance andInfection Control 154XI. Concerns of Health Personnel 155XII. Conclusion 155References 156I. INTRODUCTIONII.BIOLOGICAL EFFECTSTransesophageal echocardiography (TEE) is now widelyused as a diagnostic and monitoring instrument. The proximityof the probe location in the esophagus, immediatelyposterior to the heart, facilitates higher quality imageacquisition in comparison with the transthoracic techniquewhere bones and lungs interfere. European and Americangroups have published recommendations describing theminimal requirements for complete TEE examination(1). This chapter will discuss the biological effects of diagnosticultrasound. The method, anatomy, preparation, andsafety of the TEE examination will also be reviewedtogether with various complications.Diagnostic ultrasound is a valuable modality. To date,there is no contraindication when medical benefit isexpected. No confirmed biological effects have beenreported resulting from exposure to the present diagnosticultrasound instruments in humans, including its use indiagnostic cardiac imagery. Ultrasound operators have tounderstand potential bioeffects, assess the benefits vs therisks of a procedure for a patient, possess and maintainhigh levels of technical skill and apply the ALARA principle(ALARA principle “as low as reasonably achievable”).The bioeffects of ultrasound include thermalcavitation and other minor and experimentally observed141