TITLE: A REAL TIME TEE TEACHING TOOL FOR TRAINEE ANESTHETISTS

AUTHORS: Sony Jacob, MD¹, Ripudamanjit Singh, FRCA²
AFFILIATION: ¹University of Pennsylvania, Philadelphia, PA; ²Mayo Foundation, Rochester, MN.

INTRODUCTION: TEE has evolved to be an effective diag- nostic tool for cardiac and hemodynamic evaluation in the OR for cardiac and non cardiac surgeries. A software tool to facilitate intraoperative TEE teaching in a real time fashion will provide a learning environment away from the OR for more number of trainees. Features like multiple frame grabbing, storing and archiving images along with annotation capability will improve the efficiency. A real time or recorded video input "plug-in" giving the procedural aspects is an added feature.
METHODS: An intelligent platform is specifically designed for TEE teaching and case discussions of echo images in a "satellite operating room environment". A client/server architecture with features of archiving, retrieving, storing, interpreting and annotating different echo images forms the infrastructure. The primary language of development is Visual basic programmed on a 32 bit platform. A user friendly GUI application and a server on Windows NT forms the back bone. The front end has different menu options with facilities to open two images at one point of time. Viewing the video images or the recorded echo is an added feature. Active X technology is used to build the functionalities to enhance simultaneous viewing as well as structured archiving.
RESULTS: An easy to use Graphical User Interface (GUI) permits access to the package allowing facile access to the system functionality. Images and data can be accessed, rendered and archived in a real time fashion. The video 'plug in' creates a viewing environment, thus making the whole package easy for trainees at different levels to understand. Annotation of grabbed images is an added feature. This package permits TEE image teaching in a real time fashion or a simulated real time scenario. The multi-tier architecture makes the package more robust, scalable and manageable, moreover easy to reuse and modify code for further developments.
DISCUSSION: An interactive real time teaching platform for TEE images will improve the learning curve of trainee anesthetists.
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1.) Anesth Analg. 1995 Mar;80(3):454-8.

2.) Int J Clin Monit Comput 1993 Nov;10(4):235-45.

3.) Mayo Clin Proc 1994 Sep;69(9):856-63.