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Abstract
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Did you know that April is Distracted Driving Awareness month? In an effort to highlight the dangers that distracted driving poses to each of us, the National Safety Council (NSC) created this annual designation. It is estimated that nearly ten people are killed every day by drivers who are inattentive to driving (e.g., talking or texting on the phone; eating or drinking; playing with the music or navigation systems; as well as mental distractions and daydreaming). More than 50% of teen crashes are from driver distraction. Extreme examples include applying make-up and changing clothes while driving. For maximal driving safety, it is important to fully focus on driving to reduce the 3000+ preventable yearly fatalities.
I recall teaching my children to drive and having them provide a constant narrative as their eyes scanned the road and they told me what they were thinking (e.g., I'm slowing down to turn left) and seeing (e.g., there is a cyclist about to cross the street). By hearing their thought-process, I was better able to appreciate their driving skills beyond the basic steering wheel and pedal manipulations.
I think there are many components of 'distracted driving' on the roads that equally apply to 'distracted reading' in the echo lab. I was just finishing a long three-hour echo reading session when I realized I had read the same echo multiple times (and I still wasn't certain I had carefully excluded endocarditis, requiring me to re-review each valve yet again - a 4th time). During this single echo study, I think I answered two phone-calls, returned four texts, and was interrupted by the fellowship program coordinator at least once. It was clear to me that I had become the proverbial distracted driver. Although I realize that I am not placing others directly in risk from a traumatic 75mph lapse in attention, I feel I was nevertheless placing others in risk.
I anticipate that you have driven home from work or another frequent route when you found yourself at your destination with barely any recollection of the drive itself? You drove using muscle-memory; auto-pilot took over. I suspect that this may have also happened to you at some point when you were reading an echo (or another imaging study that you read with confidence and high frequency). In my opinion, we all need to focus on what we are tasked with in the moment to maximize our talents. I created the table below, showing examples of tasks where distraction can happen and the possible risks when it does.
Are you familiar with Speedir (https://youtu.be/AV1RmRPSVTE)? This is a Driver Fatigue Monitoring System that uses artificial intelligence (AI) facial recognition algorithms to quickly and accurately measure indicators of drowsiness (blinking speed, yawning, head tilting) or distraction (tracking eye direction) and sounds an alarm when necessary. It struck me that I would benefit from a similar tool to keep my focus on echo reading, but alas, no such tool exists (…at least, not yet).
In this issue of CASE, you will once again have an opportunity to learn from your peers as they highlight good examples of routine findings as well as recognizing some extraordinary novel findings that travel through their echo labs. There is an absolutely beautiful primer on transcatheter mitral valve-in-ring thrombosis that highlights the complementary role of echo and x-ray from Hayes et al.; the theme of multimodality imaging continues with Jiang et al. and Mori et al., who demonstrate how to better visualize the 'rare route of metastasis along a pulmonary vein into the LA' and diagnose 'wild-type transthyretin amyloid cardiomyopathy,' respectively. There are a list of congenital findings reminding us once again that you are never too old or too young to be diagnosed with congenital heart disease: an important image to recognize is provided by Okoli et al. to make sure you don't miss an anomalous origin of the RCA from the left SOV (see cover image); Kawamura et al. explore the difficulties of diagnosing aortic stenosis in the setting of aortic coarctation with a reduced LVEF; and Bischoff et al. found that the neonatal cardiomyopathy was actually due to a coronary thrombus picked up with advanced echo tools. Lastly, in the Interventional Echo section, we are treated to a nice illustration of TEE-guided TV-vegetation aspiration by Stoker et al. and something that was entirely novel to me from Xu et al: echo-guided PIMSRA (Percutaneous Intramyocardial Septal Radiofrequency Ablation) for HCM with recurrent obstruction after failed alcohol septal ablation. Every month I learn a lot from reading over these CASEs, and I hope you do as well.
Language: en |