Anesthesiologists who received specialized training in focused cardiac ultrasound reported using those skills to improve management and guide cardiopulmonary resuscitation (CPR) in the perioperative setting, according to a study presented by anesthesiologists from Hospital for Special Surgery (HSS).

This specialized training, known as focus assessed transthoracic echocardiography (FATE), is a powerful set of clinical skills that enable anesthesiologists to more rapidly evaluate for potentially worrisome heart and lung conditions that can occur in the surgical setting, but might otherwise be missed without the use of ultrasound imaging.

"Few courses are currently available to adequately train physicians on how to incorporate this tool into their daily practice," said Stephen C. Haskins, MD, anesthesiologist and lead investigator for the study.

FATE training allows anesthesiologists to combine ultrasound evaluation of the heart and lungs at the bedside as a supplement to traditional means of assessment, such as interpretation of vital signs and analysis with a stethoscope. The ability to look inside with ultrasound imagining enables anesthesiologists and surgical teams to respond quickly and more effectively to potentially life threatening conditions such as hypovolemia and pneumothorax.

Researchers reviewed survey response data from 59 clinicians who indicated they had regional anesthesiology training or regularly practice regional anesthesia who underwent basic FATE certification at HSS for their study, which was presented at the annual meeting of the American Society of Regional Anesthesiologists.

"This formal evaluation of the basic FATE course provides insight into how FATE is used to guide clinical decision making for practicing regional anesthesiologists and helps identify major barriers to its implementation," said Dr. Haskins.

Of the respondents, 86 percent believe that FATE training should be mandatory in an anesthesia academic curriculum and 45.8 percent reported using FATE to guide clinical decision making since completing the course – including using FATE skills to assess for left ventricular function, hypovolemia, and pneumothorax. Although 49 percent of past participants agreed or strongly agreed that FATE training has positively improved their current practice, 51 percent of survey respondents reported a lack of opportunity and 41 percent reported a lack of resources barring them from using these skills in the operating room.

"Implementation of a formal training course in FATE is associated with a positive change in current professional practice. More universal adaptation of focused cardiac ultrasound training, such as FATE, should be adapted by anesthesia training programs, noted the researchers." noted Dr. Haskins.