Echocardiogram Patient Care and Safety in Echocardiography 2 — Questions and Answers
Question 1: During a transesophageal echocardiogram (TEE), a patient's oxygen saturation drops to 85%. What should the technician do first?
- Increase the depth of sedation
- Alert the physician immediately and prepare to withdraw the probe (Correct answer)
- Reposition the probe for a better view
- Continue monitoring and document the finding
Correct answer: Alert the physician immediately and prepare to withdraw the probe
Oxygen desaturation below 90% during TEE is a safety endpoint requiring immediate physician notification and possible probe removal.
Question 2: Which document must be obtained from a competent patient before performing a transesophageal echocardiogram?
- Advance directive
- Written informed consent (Correct answer)
- Insurance pre-authorization
- HIPAA acknowledgment
Correct answer: Written informed consent
Informed consent is required for invasive procedures like TEE; it documents that the patient understands the risks and agrees to proceed.
Question 3: A patient has a latex allergy. What precaution is specifically needed during an echocardiographic examination?
- Avoid using any ultrasound gel
- Use latex-free gloves and verify probe covers are latex-free (Correct answer)
- Perform the study in the ICU only
- Administer prophylactic antihistamines before the study
Correct answer: Use latex-free gloves and verify probe covers are latex-free
Latex-free gloves and latex-free probe covers prevent allergic reactions in latex-sensitive patients during the examination.
Question 4: When caring for a patient on droplet precautions, which personal protective equipment (PPE) is required for the echocardiography technician?
- N95 respirator and full gown only
- Surgical mask, gloves, and eye protection (Correct answer)
- Sterile gloves and surgical cap
- Gloves only, as ultrasound poses no aerosol risk
Correct answer: Surgical mask, gloves, and eye protection
Droplet precautions require a surgical mask, gloves, and eye protection to prevent exposure to respiratory droplets within 3–6 feet.
Question 5: What is the appropriate response if an electrocardiogram (ECG) lead placed during echocardiography shows sustained ventricular tachycardia?
- Document it and continue the study
- Remove the ECG leads and proceed
- Stop the examination, activate emergency response, and stay with the patient (Correct answer)
- Increase the ultrasound output to complete the study quickly
Correct answer: Stop the examination, activate emergency response, and stay with the patient
Sustained ventricular tachycardia is a life-threatening arrhythmia requiring immediate activation of the emergency response team.
Question 6: Which action helps prevent patient falls when assisting an elderly patient onto an examination table for an echocardiogram?
- Ask the patient to climb up unassisted to promote independence
- Lock the wheels of the examination table and provide a step stool with handrails (Correct answer)
- Raise the table to its highest position for easier access
- Have the patient sit on the floor to avoid falling
Correct answer: Lock the wheels of the examination table and provide a step stool with handrails
Locking the table and providing stable support reduces the risk of falls, which are a leading cause of patient injury in clinical settings.
Question 7: When performing echocardiography on a pregnant patient, which ALARA measure is most important?
- Use maximum mechanical index settings
- Minimize dwell time in Doppler modes and avoid unnecessary M-mode scanning (Correct answer)
- Increase gain to reduce the number of scan passes needed
- Avoid all Doppler imaging throughout the examination
Correct answer: Minimize dwell time in Doppler modes and avoid unnecessary M-mode scanning
Minimizing Doppler exposure time reduces thermal and mechanical bioeffects in accordance with ALARA, especially important in pregnant patients.
Echocardiogram Patient Care and Safety in Echocardiography 2
During a transesophageal echocardiogram (TEE), a patient's oxygen saturation drops to 85%.
What should the technician do first?