H.A.R.T.scan ®
Haemodynamic Echocardiographic Assessment
in Real Time
Click here to register for this workshop
Workshop Fee AUD $1300.00 inclusive of GST
H.A.R.T.scan® is a registered name.
1. Course overview
The workshop is divided into two components; the theoretical part and the two-day workshop.
Theory
Tutorials will be supplied via a customised software application, further details on how to download the Student App is provided in this document. Please study these tutorials before attendance to the workshop. We will not go over the theory during the workshop as the focus is on the hands-on practice; however having the theoretical knowledge base would be beneficial to your learning.
The aim of the tutorials is to provide a good understanding of echocardiography. There is a lot of information in the tutorials and it is recommended that you spend approximately 20 hours to study prior to the workshop. Please contact us if you have any questions regarding the course content.
Some of you may have enrolled or completed the Postgraduate Certificate/Diploma in Clinical Ultrasound and Echocardiography will notice that some of the tutorials are modified for the workshop.
Workshop
The second part of the course is the two-day workshop where you come to practice on the ultrasound machines. The aim is to obtain enough practice in order to give you the confidence to start doing it yourself.
There will be six bays; each bay will have a demonstrator who performs echocardiography or ultrasound examination on a clinical model. Participants are divided into six groups and be rotated through the six bays in order to cover all aspects of the course.
The Skill Sets are as follows
1. Learn how to acquire the TTE views
2. Understand Haemodynamic Sate Assessment
3. Limited valve assessment using 2D and colour flow Doppler
4. Putting it all together – doing a HEARTscan
2. Historical Development of This Course
Echocardiography has seen a meteoric rise in use in ultrasound since the mid-1990s in Australia and around the world. The use of ultrasound to guide procedures has been used extensively by Radiologists for years, but in recent times Anaesthetists, Intensivists and Emergency Department Physicians have embraced the technology.
Limited echocardiography is not a totally new concept. There are publications looking at the use of limited echocardiography to assess volume or systolic function or as a screening tool to rule out severe aortic stenosis. Haemodynamic state assessment is a concept that has been championed through the Postgraduate Certificate/Diploma in Clinical Ultrasound (see www.heartweb.com.au).
The goal is to strike a balance between “too little and too much” by analysing the important information needed for the critical care environment, in order to influence how to manage patients. Also, a limited study should be non-invasive and brief so that it does not interfere with all the other aspects of providing critical care management whether that is in the OR, ICU or ED.
In ranking the information, Haemodynamic state assessment is really the “bread and butter” of echo information. The information will be used in 90% of clinical situations to change the management. However, haemodynamic state is not enough to fully categorise the problem. Findings of haemodynamically important valve lesions such as severe aortic stenosis, will also lead us to change management.
This created the dilemma of how much valve assessment should be included into the examination. Within echocardiography there is such a vast difference in the knowledge base required to perform a limited exam and interpretation versus diagnostic grading of valve lesions using multiple modalities such as 2D, colour flow Doppler and quantitative Doppler. The compromise is to use 2D and colour flow Doppler only, and to grade valve lesions as “ok” or “potentially bad” which will be explained in the tutorials. How to discriminate a valve lesion that could lead to haemodynamic compromise vs. one that does not will be covered.
We have placed a special tick box in the report to remind you about referring the patient for a follow up comprehensive echo when you identify a problem.
Remember, this scan is to help you manage patients in real time rather than to make you into a diagnostic echocardiographer - if you are in doubt, please refer and follow up! We are promoting the concept of limited transthoracic echocardiography to perform Haemodynamic Echocardiography Assessment in Real Time, or H.A.R.T.scan? ® for short. The study should take about 5 minutes once you gain more experience through practice. It can be repeated as often as required without causing any risk to patients. This technology may well be an important future development in perioperative management of patients.
3. The Course Development Team
The course is administered through The University of Melbourne. The University provides an extensive infrastructure required to run an educational program of this nature. The course directors are Colin and Alistair Royse, who head the Ultrasound Education Group, The University of Melbourne.
A steering committee comprising of experienced educators in echocardiography in Australia and New Zealand, such as, David Canty, John Faris, Lenore George, Peter Hebbard, Roman Kluger, Ajay Kumar, Paul Soeding, Michael Veltman, Konstantin Yastrebov, Chris Ashley, Alwin Chuan and Clement Fong was formed in the early stages of development.
Members of the steering committee were involved in course preparation including setting the educational objectives, coordinating subjects, liaising with individual tutors, and setting examinations. Many of these colleagues are demonstrators for the hands-on workshops. We are also indebted to our consultant echocardiographers and the events team. Although this has been a group effort, special acknowledgement must go out to our TTE gurus from Perth, Michael Veltman and John Faris, who have helped to evolve our concepts of limited TTE into the H.A.R.T.scan? ® format.
