All intensivists need echocardiography skills in the 21st century

The value of echocardiography to the intensivist has been well recognised in the past two decades. Regular reviews of the subject can be found in all major journals. Most intensivists surveyed feel that echocardiography is the way of the future. Yet, despite the undisputed advantages of echocardiography, uptake of the technique into the intensive care unit has been slow. Reasons for this are multiple, and include conservatism among senior clinicians and limited availability of equipment. Above all, the lack of a consistent and widely available education program has limited the opportunities for intensive care trainees to learn echocardiography. There is a need for a "three-tier" program, where all intensivists learn the basic skills to perform a focused examination on a patient whose condition is unstable, while those with a special interest develop more comprehensive skills or go on to lead a critical care echocardiography program.