02. Transesophageal echocardiography - installation

The transesophageal route, however, remains the route of choice for echocardiography in a sedated, mechanically ventilated patient. Most of the different effects have their counterpart in the transthoracic route. It is essential to display the airway pressure signal on the echocardiograph screen throughout the hemodynamic study, so as to pinpoint cardiac events in the respiratory cycle.

Figure 1 shows the installation of the echocardiograph in the patient's room. This installation depends on the architecture of the department, the size of the device and the medical habits. Our practice is to position the echocardiograph on the right side of the patient.
In addition to the multiplane probe, which is placed on a sheet on the patient, the examination requires a tooth block and KY to lubricate the probe and facilitate its introduction.

The introduction of the probe is done blindly, with the dental block in place; it is important to never force it to avoid complications.

In case of difficulties, dislocation of the mandible is of great help (figure 2, panel a) as well as flexion of the neck (figure 2, panel b). In both cases, the cooperation of a second person is required.

In exceptional cases, if the introduction of the probe with these simple means fails, it can be done under visual control using a laryngoscope.