Interior Body Scanning

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Permalink Reply by Joe P. on November 5, 2009 at 12:38pm

It would be interesting to see how many transport and treatment decisions are made because of the extra information gleamed from including an ultrasound exam. Hopefully they have their ducks in a row to publish a paper on their results.

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Permalink Reply by dr-exmedic on November 5, 2009 at 8:45pm

I can't speak to any prehospital use, but I can speak to ultrasound training.

As 4th-year medical students, we were taught the FAST exam (which is what it sounds like they're doing) in about 15 minutes + practice time. I could probably teach it to anyone who hadn't done a cadaver anatomy course (laypeople, even) in an hour or two + practice time. 25 supervised scans in the hospital is plenty to perfect it. (Important caveat: this involves nothing about the physics of ultrasound, how to tweak the machine for best view, troubleshooting, anatomical variants, all those other things. That takes extra time.) There are actual several studies out there showing that medics can learn this in a short course. No big deal thus far.

There is where everything kind of ends. Once you've got it down pat, how often do you do it? In this particular case, Temple Terrace is a town of 23,000 or so people (thank you, Wikipedia), so I can't imagine they'll be doing tons of them daily--is everybody going to be motivated enough after the first few months to scan random people just for the practice? Are they far enough from the hospital to have time to do so? How quickly do the skills atrophy if they don't? And now that you have these $18k machines sitting in the back of your ambulances, how much further do you go with expanded uses?

Another question: how many people with positive scans weren't going to end up at a trauma center based on other criteria? I don't think anyone knows the answer to that one, but if the answer turns out to be zero, what was the point?

My biggest question: if you got $54k in grant money, what would be the better choice: buying 3 US machines, or adding that to your training budget for other, low-tech stuff? For the US machines to make sense, the rest of your system already has to be top-notch.

I congratulate them for going out on a limb and doing something that everyone else isn't doing. Whether it turns out to be a good idea depends entirely on what they end up doing with it from here.

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