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Introduction:
Resource and logistical constraints may limit the availability of commercial ultrasound (US) transmission gel (USTG) in austere environments. Glucomannan powder, a dietary fiber supplement, can be mixed with tap water to form a gel that may be a field-expedient substitute for USTG. We compared glucomannan gel with a commercial USTG f...
Contexts in source publication
Context 1
... total of 193 US video clips were recorded and independently reviewed by 4 emergency US fellowshipÀtrained clinicians (Figure 1). For diagnostic adequacy, commercial USTG was sufficient 96.6% of the time (375 of 388 "yes"), and glucomannan USTG was adequate in 93.5% of its utilizations (359 of 384 "yes") ( Table 2). ...
Context 2
... total of 193 US video clips were recorded and independently reviewed by 4 emergency US fellowshipÀtrained clinicians (Figure 1). For diagnostic adequacy, commercial USTG was sufficient 96.6% of the time (375 of 388 "yes"), and glucomannan USTG was adequate in 93.5% of its utilizations (359 of 384 "yes") ( Table 2). ...
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Citations
... 5 When compared to commercial ultrasound gel, it provided comparable image quality with slightly lower diagnostic adequacy. 6 Intravenous fluid (IVF) bags are readily available in nearly any clinic, inpatient area, or field bag. Their use for this purpose may help reduce the logistical burden associated with care in resourcerestricted areas. ...
Introduction
Point-of-care ultrasound (POCUS) is a tool undergoing expanding use in military medicine, including routine inpatient, outpatient, and operational environments. Specific musculoskeletal POCUS examinations require additional equipment in the form of a standoff assist device to maximize image acquisition. These devices may not be readily available to POCUS users in more austere or resource-constrained environments. We devised a study to determine if intravenous fluid bags of various volumes could be substituted for standard standoff devices in musculoskeletal POCUS.
Materials and Methods
Sequential images of a soft tissue foreign body model, an interphalangeal joint, and a chest wall were taken using a gel standoff pad or water bath and compared to images acquired using three different sizes of intravenous fluid bags after removing excess air from the bags. Images were de-identified and scored for quality using a visual analog scale. We used a two-factor analysis of variance without replication to analyze the differences in image quality between standoff devices, with a P-value less than.05 considered statistically significant.
Results
We performed 13 POCUS studies and had a group of eight POCUS-trained physicians and physician assistants score these studies, resulting in 104 total quality scores. There was no significant difference in image quality between standoff devices for chest (P-value.280) and hand (P-value 0.947) images. We found a significant difference in image quality between standoff devices for the soft tissue foreign body model (P-value 0.039), favoring larger intravenous fluid bag standoff over standard devices.
Conclusions
In the absence of a standard commercial gel standoff device or water bath, intravenous fluid bags of 50, 100, and 250 mL can facilitate quality image acquisition for musculoskeletal POCUS.
... The dispersed solution was homogenized by the magnetics stirrer then left at room temperature for one day to complete the polymer swelling [9]. PVA formulations (F4-F6) were prepared by using the hot method in which 70ml D.W that contain 0.2gm methyl hydroxyl benzoate and 5ml Glycerin heated to 70 ᵒC in a beaker for 10 min followed by slow addition of PVA amount, then complete the volume to 100 ml by D.W. Finally the PVA dispersion was left to cool at room temperature for a viscous clear dispersion production [10]. Evaluation of 5-FU ...
... This test was considered for visual characteristics, which include homogeneity, clarity, and consistency [10]. ...
Despite significant advances in tactical combat casualty care provision over the past three decades, the integration of novel technologies designed to enhance battalion-level field and combat care over this time has been minimal. Recent data suggest an underutilization of the battalion aid station (BAS) during recent conflicts, leading to renewed interest in the value and role of the BAS in battlefield care provision. Due to its portability, versatility, affordability, and durability, ultrasound is a unique technology that could substantially reshape Role 1 care. Ultrasound’s versatile capabilities as a diagnostic and treatment adjunct in resource-constrained environments are well-described, but its potential value to battlefield care provision remains underrealized. We describe how current Role 1 capabilities may limit BAS value and utilization, ultrasound’s potential to enhance Role 1 care on future battlefields, and the vital role Army Medical Specialist Corps physician assistants continue
to play in addressing the challenges and opportunities to widespread ultrasound adoption to enhance forward military field care.
Introduction:
Point-of-care ultrasound (POCUS) is utilized in austere environments because it is lightweight, durable, battery powered, and portable. In austere settings, weight and space constraints are limitations to carrying dedicated ultrasound gel. Few studies have assessed commonly carried liquids as gel alternatives. The study objective was to assess the suitability of common food and personal care products as ultrasound coupling agents compared with that of commercial gel.
Methods:
A noninferiority study compared 9 products to commercial gel. Each substance was independently tested on 2 subjects by 2 sonographers covering 8 standardized ultrasound windows. Clips were recorded, blinded, and independently graded by 2 ultrasound fellowship-trained physicians on the ability to make clinical decisions and technical details, including contrast, resolution, and artifact. A 20% noninferiority margin was set, which correlates to levels considered to be of reliably sufficient quality by American College of Emergency Physicians' guidelines. The substances included water, soap, shampoo, olive oil, energy gel, maple syrup, hand sanitizer, sunscreen, and lotion.
Results:
A total of 300 of 318 (94%) clips met the primary endpoint of adequacy to make a clinical decision. All media, except sunscreen, were noninferior to commercial gel in the ability to make a clinical decision (α=0.05). In terms of secondary outcomes, resolution, artifact, and contrast, all substances were noninferior to commercial gel (α=0.05). The sonographers concluded that all gel alternatives' usability performed similarly to commercial gel, with the exception of energy gel.
Conclusions:
Of the 9 substances tested, 8 were noninferior to commercial gels for clinical decisions. Our study indicates that several POCUS gel substitutes are serviceable to produce clinically adequate images.
