Piloting structured focused TTE in outpatients during the COVID-19 pandemic: 'old habits die hard'

Transthoracic echocardiography presents a risk of COVID-19 transmission between an echocardiographer and the patient. Reducing the scanning time is likely to mitigate this risk for them both. British Society of Echocardiography (BSE) level 1 echocardiography offers a potential framework for focused scanning in an outpatient setting. There were 116 outpatients scheduled for a level 1 scan supplemented with additional predefined views, if required. Unexpectedly, a fifth of the scans were performed as an unintended full scan for a variety of reasons. Our results showed that focused scans were performed more quickly than full scans and below the NHS Test and Trace exposure cut-off of 15 minutes. However, if more than three sets of additional measurements were required then a full scan could be performed more quickly. Seniority of the echocardiographer and scan time had an inverse relationship. By examining the patients' clinical records we were confident that all of the scans, whether focused or full, had answered the requestor's clinical question. Although the COVID-19 vaccination programme should reduce the necessity of minimising exposure time during a scan there could still be a role for level 1 scanning during the COVID-19 recovery programme to tackle the vast lists of patients waiting for an echocardiogram.