Learning and competence in critical care echocardiography

Abstract

Critical care echocardiography (CCE) has specific requirements that cannot be met by consultant cardiologists and support the need for training intensivists in the use of this technique in the intensive care unit (ICU). Hemodynamic monitoring utilizing echography is made in two steps: the first assesses the main mechanisms implicated in the problem (ventricular dysfunction, preload deficit, tamponade), and this can be done by most intensivists with minimal training; the second step evaluates in more detail the precise cause and the various abnormalities presented by the patient's heart; this step requires more expertise. The training for beginners can easily be achieved with basic courses and a minimal number of assisted and nonassisted echocardiographic examinations. Intensivists who desire to reach competence in advanced CCE must dedicate time to follow an extensive training program to acquire technical and cognitive skills for mastering all aspects of echocardiography in the ICU setting. Competence in advanced CCE should be officially recognized. With accumulated experience, intensivists with competence in advanced CCE will attain expertise and may act as tutors for other physicians in training. Each country should built structured educational programs based on existing international standards. © 2011 Springer-Verlag Berlin Heidelberg.