Andrea R Levine1, Michael T McCurdy2, Marc T Zubrow3, Alfred Papali4, Haney A Mallemat5, Avelino C Verceles6. 1. Department of Medicine, University of Maryland School of Medicine, 22 S. Greene St., Baltimore, MD, 21201, United States. Electronic address: Alevine1@umm.edu. 2. Division of Pulmonary and Critical Care, University of Maryland School of Medicine, 110 S. Paca St., 2nd Floor, Baltimore, MD, 21201, United States; Department of Emergency Medicine, University of Maryland School of Medicine, 110 S. Paca St., 6th Floor, Baltimore, MD, 21201, United States. Electronic address: drmccurdy@gmail.com. 3. Program in Trauma, University of Maryland School of Medicine, 655 W. Baltimore Street, Baltimore, MD, 21201, United States; University of Maryland eCare, University of Maryland Medical System, 110 S. Paca St., Suite 5-N-162, Baltimore, MD, 21201, United States. Electronic address: mzubrow@umm.edu. 4. Division of Pulmonary and Critical Care, University of Maryland School of Medicine, 110 S. Paca St., 2nd Floor, Baltimore, MD, 21201, United States. Electronic address: apapali@umm.edu. 5. Department of Emergency Medicine, University of Maryland School of Medicine, 110 S. Paca St., 6th Floor, Baltimore, MD, 21201, United States. Electronic address: hmallemat@umm.edu. 6. Division of Pulmonary and Critical Care, University of Maryland School of Medicine, 110 S. Paca St., 2nd Floor, Baltimore, MD, 21201, United States. Electronic address: avercele@medicine.umaryland.edu.
Abstract
PURPOSE: Intensive care unit telemedicine (tele-ICU) uses audiovisual systems to remotely monitor and manage patients. Intensive care unit ultrasound can augment an otherwise limited bedside evaluation. To date, no studies have utilized tele-ICU technology to assess the quality and clinical use of real-time ultrasound images. We assessed whether tele-intensivists can instruct nonphysicians to obtain high-quality, clinically useful ultrasound images. METHODS: This prospective pilot evaluated the effectiveness of a brief educational session of nonphysician "ultrasonographers" on their ability to obtain ultrasound images (right internal jugular vein, bilateral lung apices and bases, cardiac subxiphoid view, bladder) with real-time tele-intensivist guidance. All ultrasound screen images were simultaneously photographed with a 2-way camera and saved on the ultrasound machine. The tele-intensivist assessed image quality, and an independent ultrasound expert rated their use in guiding clinical decisions. RESULTS: The intensivist rated the tele-ICU camera images as high quality (70/77, 91%) and suitable for guiding clinical decisions (74/77, 96%). Only bilateral lung apices demonstrated differences in quality and clinical use. All other images were rated noninferior and clinically useful. CONCLUSION: Tele-intensivists can guide minimally trained nonphysicians to obtain high-quality, clinically useful ultrasound images. For most anatomic sites, tele-ICU images are of similar quality to those acquired directly by ultrasound.
PURPOSE: Intensive care unit telemedicine (tele-ICU) uses audiovisual systems to remotely monitor and manage patients. Intensive care unit ultrasound can augment an otherwise limited bedside evaluation. To date, no studies have utilized tele-ICU technology to assess the quality and clinical use of real-time ultrasound images. We assessed whether tele-intensivists can instruct nonphysicians to obtain high-quality, clinically useful ultrasound images. METHODS: This prospective pilot evaluated the effectiveness of a brief educational session of nonphysician "ultrasonographers" on their ability to obtain ultrasound images (right internal jugular vein, bilateral lung apices and bases, cardiac subxiphoid view, bladder) with real-time tele-intensivist guidance. All ultrasound screen images were simultaneously photographed with a 2-way camera and saved on the ultrasound machine. The tele-intensivist assessed image quality, and an independent ultrasound expert rated their use in guiding clinical decisions. RESULTS: The intensivist rated the tele-ICU camera images as high quality (70/77, 91%) and suitable for guiding clinical decisions (74/77, 96%). Only bilateral lung apices demonstrated differences in quality and clinical use. All other images were rated noninferior and clinically useful. CONCLUSION:Tele-intensivists can guide minimally trained nonphysicians to obtain high-quality, clinically useful ultrasound images. For most anatomic sites, tele-ICU images are of similar quality to those acquired directly by ultrasound.
Authors: Jason Stankiewicz; Maniraj Jeyaraju; Andrew R Deitchman; Avelino C Verceles; Alison Grazioli; Michael T McCurdy Journal: ATS Sch Date: 2021-11-30
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Authors: Jessica M Scott; Meghan Downs; David S Martin; Erik Hougland; Laura Sarmiento; Natalia Arzeno; Donald R Pettit; Robert Ploutz-Snyder; David Cunningham; Lee W Jones; Richard Do; Lori Ploutz-Snyder Journal: iScience Date: 2021-03-21