Extreme musculo-skeletal ultrasound: training of non-physicians in the Arctic Circle

Abstract

Objective The purpose of this study was to compare if non-physician, inexperienced ultrasound subjects can take quality diagnostic images after watching a brief educational video and using reference cue cards (autonomous group) versus taking ultrasound images with expert guidance using a satellite connection. Methods Six non-medical, inexperienced ultrasound subjects from a rural area (Arctic Circle) obtained ultrasound images of target anatomic regions using a portable ultrasound device after receiving expert-guided training or autonomous training (educational video and cue cards). Real-time expert guidance was provided using an audiovisual tele-ultrasound connection with direct ultrasound video compression which was relayed to a remote expert via a secure satellite connection. The resultant images from all studies were blindly reviewed by imaging experts for determination of diagnostic adequacy. Results All of the examinations were completed in \15 min. The blinded expert identified 85.1% of autonomously acquired images and 86.2% of the images obtained by expert guidance to be of diagnostic quality; there was no statistical difference between the two groups (P = 0.6653). Conclusion Non-physician, inexperienced subjects can quickly educate themselves to retrieve diagnostic quality ultrasound images whether they are being expert-guided or trained autonomously.

Potential Use of Remote Telesonography as a Transformational Technology in Underresourced and/or Remote Settings

“…Using such a system, McBeth et al conducted a series of trials with the assistance of healthy volunteers at a variety of remote sites to demonstrate the feasibility and applicability of these techniques conducted primarily over a smartphone [18, 19]. Other investigators have also utilized a variety of commercial video-streaming devices to transmit real-time streaming ultrasound images over either the internet [33] or satellite transmission [34, 35], with potential remote guidance potentially conducted by telephone or without a video camera depiction of the user [34, 35]. …”

Just-in-Time Cost-Effective Off-the-Shelf Remote Telementoring of Paramedical Personnel in Bedside Lung Sonography—A Technical Case Study

“…1,5,6 Although these initial efforts created the field of real-time RTMUS, ongoing efforts have attempted to simplify and spin-off the technology/ technique for terrestrial use. 7,8 Accordingly, we report the first utilization of a novel simplified cost-effective RTMUS to mentor inexperienced health professionals to perform advanced bedside ultrasound exams after tube thoracostomy (TT) removal.…”

Use of bedside ultrasound by non-radiologists for the rapid diagnosis of life threatening condition

“…Farsi D et al, suggested that cardiac ultrasound by trained emergency medicine residents is comparable to echocardiography performed by cardiologists and it could be used as a reliable tool and screening test for initial testing of patients suspected of cardiac abnormalities in the acute setting (5). Two nonrandomized studies concluded that non-radiologist doctors could use of portable ultrasonography, effectively, in musculoskeletal disorders after a short training session (6,7). This shows that bedside ultrasonography would be widely used especially in emergencies.…”