On the 50th anniversary of Sir Edmund Hillary and Tensing Norgay's historic trip to the summit of Mount Everest, a team of German medical scientists from the University of Giessen attached themselves to a group of mountaineers looking to replicate Hillary and Norgay's success. Amongst the usual types of equipment packed for such a trek was one unusual one - 20-pound ultrasound system. The Siemens Acuson Cypress was a key tool for the scientists to investigate changes in cardiac performance and lung function at extreme altitudes during an expedition to the summit of the world's highest mountain.
Over the past five years, rapid advances in ultrasound technology have made these systems more compact while increasing their ability to handle complex applications and provide greater image quality. Ground-breaking studies like the one performed on Mount Everest are now possible in the field due to the technology's portability. Even within the hospital, clinic, or private practice, great clinical feats are being accomplished every day in Ob/gyn, pediatrics, emergency medicine, and radiology.
Patient-centric care is one of the great benefits of portable ultrasound technology. For David P. Bahner, MD, assistant professor and director of Ultrasound Department of Emergency Medicine at Ohio State University, clinicians should strive to make the patient the focal point of care rather than transporting patients to and from various departments for testing.
"With [GE Healthcare's] LOGIQ Book XP, we are able to acquire excellent images faster than ever before - right in the ER - and transmit them wirelessly to the hospital network. These advances in portability and connectivity will further increase our mobility, streamline our clinical workflow and allow us to apply new diagnostic tools like ultrasound [systems] across all patient-care areas of the hospital."
The LOGIQ Book can store up to 30,000 high-quality images in a standard DICOM based format. Wireless features are available by plugging a PCMCIA card into the back of the 10-pound system. Images from the patient are captured in the LOGIQ Book, frozen, and at the touch of a program print key, either wirelessly uploaded to PACS, to a colorless or black-and-white printer, or downloaded straight to the hard drive. Bahner sees networked images as the wave of the future; he and his staff have configured the LOGIQ Book to communicate wirelessly with the facility's PACS. Once the patient has been scanned, his or her demographics are downloaded as well. This information is then uploaded to the network and patient data can be accessed and reviewed by anyone with the proper security clearance.
Learning the ropes
Yet, widespread acceptance of this new technology is hampered by what Bahner describes as "technophobia." Proper training is a barrier to use. To address this issue, Bahner has created an ultrasound academy as a centralized area to train all users of ultrasound, whether they are students, residents or sonographers. "There is a contingent that is willing to overcome [their technophobia], especially in the emergency medicine community. We have embraced the technology because if you can put the hours into understanding the knobs and start playing with the equipment, you can get more proficient. It can give you clinical images that can help in your medical decision-making." He sees motivated learners as a necessary element in broadening the appeal of ultrasound technology.
As for the future of portable and hand-held ultrasound, Bahner has noticed a rise in use by internal medicine in the critical-care environment. With the recent passage of House resolution SAVE (Screening for Aortic Aneurysm Very Efficiently), the need for a rapid diagnostic tool becomes more prevalent. The use of these systems is almost unlimited. Anytime a physician needs to look into the body or guide an intervention, ultrasound is an asset. Other areas in which the technology is finding more and more usage is in the ER for assessing serious bleeds that need quick answers. Or in pain therapy, a hand-held ultrasound system can be used to find the nerve that needs to be blocked and an anesthetic can be injected locally, avoiding general anesthesia.
Ultrasound on the go
Bringing the technology to the patient also is an important part of how sonographer Alex Cruz, owner/president of Southeast Medical Imaging, uses his Biosound Esaote MyLab. In addition to running his own lab, Cruz also performs