Tele-ultrasound and paramedics: real-time remote physician guidance of the Focused Assessment With Sonography for Trauma examination

Boniface, Keith; Shokoohi, Hamid; Smith, Edward; Scantlebury, Kari

doi:10.1016/j.ajem.2009.12.001

Cited by 85 publications

(75 citation statements)

References 9 publications

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“…32 Assuming instant availability of a trained physician at any time to "tele-mentor," this method could be both accurate and feasible. [33][34][35][36][37][38][39] However, limitations include mentor availability, a need for high-bandwidth Internet or cellular connections to maintain image quality, and technical problems such as image freezing. 39,40 Its effectiveness in clinical use has not yet been studied in rural Canada.…”

Section: Corrective Measuresmentioning

confidence: 99%

Barriers to point-of-care ultrasound use in rural emergency departments

Micks

Sue

Rogers

2016

CJEM

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Over the past few decades, point-of-care ultrasound (PoCUS) has come to play a major role in the practice of emergency medicine. Despite its numerous benefits, there has been a slow uptake of PoCUS use in rural emergency departments. Surveys conducted across Canada and the United States have identified a lack of equipment, training, funding, quality assurance, and an inability to maintain skills as major barriers to PoCUS use. Potential solutions include expanding residency training in ultrasound skills, extending funding for PoCUS training to rural physicians in practice, moving PoCUS training courses to rural sites, and creating telesonography training for rural physicians. With these barriers identified and solutions proposed, corrective measures must be taken so that the benefits of PoCUS are extended to patients in rural Canada where, arguably, it has the greatest potential for benefit when access to advanced imaging is not readily available.

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Section: Corrective Measuresmentioning

confidence: 99%

Barriers to point-of-care ultrasound use in rural emergency departments

Micks

Sue

Rogers

2016

CJEM

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“…Prior reports reveal that teleultrasound examination with limited technical resources could be clinically useful [10,11,18,31]. Likewise, paramedics with no prior ultrasound experience could obtain real-time teleultrasonography images for trauma examination under remote guidance from experienced sonographer [17].…”

Section: Discussionmentioning

confidence: 99%

“…Also, transmission of real-time video streams, from modalities like ultrasound, has been reported and applied for different purposes, such as: remote real-time fetal teleultrasound consultation, real-time remote physician guidance of assessment with sonography for trauma examination, and teleultrasound in emergency situations and humanitarian work [12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Image Quality in Real-Time Teleultrasound of Infant Hip Exam Over Low-Bandwidth Internet Links: a Transatlantic Feasibility Study

et al. 2012

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Evolution of communication systems, especially internet-based technologies, has probably affected Radiology more than any other medical specialty. Tremendous increase in internet bandwidth has enabled a true revolution in image transmission and easy remote viewing of the static images and real-time video stream. Previous reports of realtime telesonography, such as the ones developed for emergency situations and humanitarian work, rely on high compressions of images utilized by remote sonologist to guide and supervise the unexperienced examiner. We believe that remote sonology could be also utilized in teleultrasound exam of infant hip. We tested feasibility of a low-cost teleultrasound system for infant hip and performed data analysis on the transmitted and original images. Transmission of data was accomplished with Remote Ultrasound (RU), a software package specifically designed for teleultrasound transmission through limited internet bandwidth. While image analysis of image pairs revealed statistically significant loss of information, panel evaluation failed to recognize any clinical difference between the original saved and transmitted still images.

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“…There is already good evidence that ambulance paramedics can generate diagnostic-quality ultrasound images with remote support. For example, Boniface et al demonstrated that 51 paramedics with no prior ultrasound experience and only 20 minutes of training completed the Focussed Assessment with Sonography in Trauma (FAST) suite of scans very successfully and quickly (< 5 minutes) under remote direction from an Emergency Physician 29 . However, this was essentially a laboratory-type, room-to-room study and so did not replicate what might happen in real-life.…”

Section: Ultrasound Operatorsmentioning

confidence: 99%

Combining transcranial ultrasound with intelligent communication methods to enhance the remote assessment and management of stroke patients: Framework for a technology demonstrator

Mort

Eadie

Regan

et al. 2016

Health Informatics J

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With over 150,000 strokes in the UK every year, and more than 1 million living survivors, stroke is the third most common cause of death and the leading cause of severe physical disability among adults. A major challenge in administering timely treatment is determining whether the stroke is due to vascular blockage (ischaemic) or haemorrhage. For patients with ischemic stroke, thrombolysis (i.e. pharmacological 'clot-busting') can improve outcomes when delivered swiftly after onset and current NHS Quality Improvement Scotland guidelines are for thrombolytic therapy to be provided to at least 80% of eligible patients within 60 minutes of arrival at hospital. Thrombolysis in haemorrhagic stroke could severely compound the brain damage so administration of thrombolytic therapy currently requires near immediate care in a hospital, rapid consultation with a physician and access to imaging services (X-ray computed tomography (CT) or magnetic resonance imaging) and intensive care services. This is near impossible in remote and rural areas, and stroke mortality rates in Scotland are 50% higher than in London. We here describe our current project developing a technology demonstrator with ultrasound imaging linked to an intelligent, multi-channel communications device − connecting to multiple 2G/3G/4G networks and/or satellites − in order to stream live ultrasound images, video and two-way audio streams to hospital-based specialists who can guide and advise ambulance clinicians regarding diagnosis. With portable ultrasound machines located in ambulances or general practices, use of such technology is not confined to stroke, although this is our current focus. Ultrasound assessment is useful in many other immediate care situations, suggesting potential wider applicability for this remote support system. Although our research programme is driven by rural need, the ideas are potentially applicable to urban areas where access to imaging and definitive treatment can be restricted by a range of operational factors.

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Tele-ultrasound and paramedics: real-time remote physician guidance of the Focused Assessment With Sonography for Trauma examination

Cited by 85 publications

References 9 publications

Barriers to point-of-care ultrasound use in rural emergency departments

Barriers to point-of-care ultrasound use in rural emergency departments

Image Quality in Real-Time Teleultrasound of Infant Hip Exam Over Low-Bandwidth Internet Links: a Transatlantic Feasibility Study

Combining transcranial ultrasound with intelligent communication methods to enhance the remote assessment and management of stroke patients: Framework for a technology demonstrator

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