ECHO On vs Checklist Navigator

ECHO On is a free medical education resource for learning Transesophageal Echocardiography including a free, enlarging question bank, a Rescue TEE cognitive aid, a Case Log system for submission to the NBE, and a growing perioperative Quick Reference library with offline echo loops that work even in the OR without internet access, and includes pathology examples, techniques, and normal loops of the heart. ECHO On will walk you through an entire standard 28 view exam teaching you the anatomy, function and Doppler interrogations you should perform at each view, and how to interpret them. ECHO On is and will remain free, and the best way you can contribute is to submit boards-style questions or echo stills and echo loops to help grow the QBank, Quick Reference and Pathology libraries. Disclaimer: This app was written to provide an accessible perioperative tool for residents and fellows learning TEE in the cardiac OR and ICU, and for generalist anesthesiologists looking to refresh their knowledge of TEE. It is not meant for patients to self-diagnose. It is not meant to be a definitive reference. Despite my best efforts, there may be errors or inaccuracies in this app, so please do not use it for medical decision making, as doing so may lead you misdiagnose or seriously harm your patient. If you are not a qualified medical doctor, please see a qualified medical doctor before making any medical decisions, including those based on echocardiograms.

Surgical safety and anesthesia safety checklists have been proven to reduce mishaps and improve outcomes. Checklists haves also been used to improve the conduct of handoffs and to guide treatment during crises. However, executing checklists in a uniform, reproducible and reliable manner can be difficult. Checklist posters on the procedure room wall can be challenging or impossible to read at a distance, and paper checklists get misplaced. Checklists incorporated into electronic health records are often simple lists, without “smart” functionality. Computerized checklists are widely used in commercial aviation, either built in to the avionics systems, or carried onto the flight deck by the pilots on their ubiquitous computer tablets. The format and function of these computerized checklists have been carefully considered, designed and refined by aircraft manufacturing companies, airlines and test pilots. The authors of this app are anesthesiologists, software engineers, and a commercial airliner test pilot. They have incorporated aviation checklist design principles into this convenient app. Key design elements include ease of navigation, the ability to quickly identify the checklist that is required for a particular situation, a place keeper that automatically highlights the next checklist item, a change in color when checklist items are completed, a change in color of checklist items that are skipped, helping to prevent missed checklists items, which can be a cause of mishaps, and confirmation that a checklist has been completed. In addition to a brief and easily recognized description of each checklist item, a more detailed explanation of each item is also available for reference. In this inaugural version of the app, a limited library of checklists is provided, that will eventually be expanded to include many more checklists, including a full suite of crisis checklists (known as “non-normal checklists” in aviation). Current checklists include— -> Surgical safety checklists (derived from the WHO surgical safety checklists, also known as the procedural“time out”) -> Preanesthesia safety checklist (derived from the APSF preanesthesia checklist) -> Handoff checklist for safe patient handoff between care providers