Critical Care Echocardiography

Echocardiography is mainstream in critical care practice and a valued adjunct to history, physical examination, and standard investigations. Echocardiography is:

Note that this summary combines both the CICM policy for levels of training in echocardiography (IC-29) and the statement on the role of echocardiography in intensive care (IC-24).

Classifications

CICM classifies echocardiography in critical care into:

  • Focused cardiac ultrasound
  • Advanced critical care echocardiography
  • Expert critical care echocardiography

Focused Cardiac Ultrasound

  • Basic level for assessment of critically ill patients
  • Answer specific, limited range of clinical questions
    • Types of shock
    • Major physiological abnormalities
  • Required as part of the CICM curriculum
  • Requires:
    • Attendance ata an accredited course
    • A short, on-line exam
    • Completion of a 30-case logbook of ICU patients, signed off by an accredited supervisor

Advanced Critical Care Echocardiography

  • Examination with expertise similar to a cardiologist
  • Divided, based on training and experience, into:
    • TTE only
    • TTE and TOE
  • TTE requires:
    • Completion of an accredited course with exit exam
      • Physics
      • Knobology
      • Artefact formation
      • Image optimisation
      • Quantitative assessment of haemodynamic states
    • Completion of 450-case logbook
      • 2/3rds in a critical care environment
      • 300 performed and reported
      • 150 reported
    • Ongoing CPD
  • TTE and TOE requires:
    • All TTE requirements
    • 50 TOE studies
      • 1/2 performed in a critical care environment
      • 25 performed and reported
      • 25 reported

Expert Critical Care Echocardiography

  • Excellence in all aspects of practice and training
  • Involvement in echocardiography research and publications
  • Endorsed by peers
  • Requires:
    • Advanced TTE and TOE for ⩾7 years
    • Substantive involvement in education and training
    • Ongoing echocardiography CPD

References

  1. CICM. IC-29 Levels of Training in Adult Critical Care Echocardiography. 2018.
  2. CICM. IC-24 Statement on the Role of Echocardiography in Intensive Care Medicine. 2016.