mHealth Research Daily, with Tim Bredrup

Common immediate life-threatening conditions such as apnea (APN) and pneumothorax (PTX) can be easily ruled out by performing an ultrasound that visualizes a respiratory motion known as lung sliding (LS). Institutions from around the world collaborated on a study that assessed how economically and practically this information could be obtained remotely over a cellular network.

Remote expert sonographers directed remote providers with little to no ultrasound experience on how to obtain the images needed to rule out APN and PTX. Through the use of handheld ultrasound machines streaming images via Skype services on an iPhone, examinations were conducted between a series of remote sites and a base station. Sites included two remote on-mountain sites, a small airplane in flight, and a Calgary household, with base sites located in Pisa, Rome, Philadelphia, and Calgary.

In all lung fields (20/20) on all occasions, LS could easily and quickly be seen. Furthermore, the respiratory motion was easily corroborated and documented through capture of color-power Doppler and M-mode images. Other ultrasound applications such as the Focused Assessment with Sonography for Trauma examination, vascular anatomy, and a fetal wellness assessment were also demonstrated.

The study concluded that the emergent exclusion of APN and PTX can be immediately accomplished by a remote expert economically linked to almost any responder over cellular networks. It’s been suggested that further work should explore the range of other physiologic functions and anatomy that could be so remotely assessed.

As technology continues to grow in exponential fashion, it is likely that more applications of this concept will emerge going forward and the practice of telementoring will become more common place given the many advantages it can provide.

Authors:McBeth PB, Crawford I, Blaivas M, Hamilton T, Musselwhite K, Panebianco N, Melniker L, Ball CG, Gargani L, Gherdovich C, Kirkpatrick AW.

Institutions: From the Departments of Surgery (P.B.M., T.H., K.M., A.W.K.), Critical Care Medicine (A.W.K.), and Regional Trauma Program (C.G.B., A.W.K.), Foothills Medical Centre, Calgary, Alberta, Canada; University of Aberdeen (I.C.), Aberdeen, Scotland; Northside Hospital Forsyth (M.B.), Cumming, Georgia; University of Pennsylvania (N.P.), Philadelphia, Pennsylvania; New York Methodist Hospital (L.M.), New York, New York; Institute of Clinical Physiology (L.G.), National Research Council, Pisa, Italy; and World International Network Focused on Critical Ultrasound Secretariat (C.G.), Bologna, Italy.

Original Abstract:  http://www.ncbi.nlm.nih.gov/pubmed/22182864