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IntroductionThe use of telemedicine by deployed healthcare providers to improve patient care has been increasing in recent foreign conflicts and humanitarian missions. These efforts have mostly been limited to email consultation with long response lag times. The United States Military has developed several modalities of telemedicine for use in austere environments, ranging from video conferencing, email, and store-and-forward technology. As of now, these efforts have required large pieces of equipment and many technical support personnel and have a delayed response time. Our study aimed to test the overall feasibility of use, the effects on time to intervention, and user confidence in a highly portable, real-time video set-up to aid in teleconsultations at the early stages of care for a simulated traumatic injury.Materials and methodsSubjects or operators taking direct care of the simulated patient were junior emergency medicine (EM) residents or military trained medics. Video teleconsultation was completed by either senior EM residents in their final year of training or board-certified EM physicians. The subjects taking direct care of the simulated patient were blinded to whether their video device was actively sending images or not. All participants communicated verbally using hand-held radios. The total number of interventions and time to event analysis was completed and survey data were collected, assessing confidence levels on procedures performed and patient care. ResultsWe demonstrated the accessibility, ease of use, and overall practicality of this telemedicine platform. A trend was found towards decreased time to evacuation for patients with a live video feed. Alternatively, the data showed no significant difference in the addition of video as opposed to solely radio in terms of the number of interventions, time to interventions, or operator or teleconsultant confidence in the care delivered or procedures performed.ConclusionsThis study demonstrated the overall feasibility and ease of use of a highly portable telemedicine platform with live video capabilities. A trend was found toward earlier evacuation decisions when using the live video. Follow-up studies may consider examining more challenging simulations or prolonged field care utilization of this technology.

Point-of-care ultrasonography has been shown to have pervasive clinical and educational utility in medicine. The need to provide medical students with training in point-of-care ultrasonography has been recognized by an increasing number of osteopathic and allopathic medical schools. A 4-year integrated ultrasonography curriculum was implemented at Rocky Vista University College of Osteopathic Medicine in 2015. A review of the curriculum design, content, educational methods, and student feedback are described. Barriers to curriculum implementation and lessons learned, unique to integrating point-of-care ultrasonography into the osteopathic curriculum, are also discussed.

IntroductionOur goal was to determine if heated gel for emergency department (ED) bedside ultrasonography improves patient satisfaction compared to room-temperature gel.MethodsWe randomized a convenience sample of ED patients determined by their treating physician to require a bedside ultrasound (US) study to either heated gel (102.0° F) or room-temperature gel (82.3° F). Investigators performed all US examinations. We informed all subjects that the study entailed investigation into various measures to improve patient satisfaction with ED US examinations but did not inform them of our specific focus on gel temperature. Investigators wore heat-resistant gloves while performing the examinations to blind themselves to the gel temperature. After completion of the US, subjects completed a survey including the primary outcome measure of patient satisfaction as measured on a 100-mm visual analogue scale (VAS). A secondary outcome was patient perceptions of sonographer professionalism measured by an ordinal scale (1–5).ResultsWe enrolled 124 subjects; 120 completed all outcome measures. Of these, 59 underwent randomization to US studies with room-temperature gel and 61 underwent randomization to heated US gel. Patient 100-mm VAS satisfaction scores were 83.9 among patients undergoing studies with room-temperature gel versus 87.6 among subjects undergoing studies with heated gel (effect size 3.7, 95% confidence interval −1.3–8.6). There were similarly no differences between the two arms with regard to patient perceptions of sonographer professionalism.ConclusionThe use of heated ultrasound gel appears to have no material impact on the satisfaction of ED patients undergoing bedside ultrasound studies.