Crawford Innes, McBeth Paul B, Mitchelson Mark, Ferguson James, Tiruta Corina, Kirkpatrick Andrew W
Department of Surgery, Foothills Medical Centre, Calgary, Alberta, AB-T2N-2T9, Canada.
Crit Ultrasound J. 2012 May 29;4(1):13. doi: 10.1186/2036-7902-4-13.
Worldwide ultrasound equipment accessibility is at an all-time high, as technology improves and costs decrease. Ensuring that patients benefit from more accurate resuscitation and diagnoses from a user-dependent technology, such as ultrasound, requires accurate examination, typically entailing significant training. Remote tele-mentored ultrasound (RTUS) examination is, however, a technique pioneered in space medicine that has increased applicability on earth. We, thus, sought to create and demonstrate a cost-minimal approach and system with potentially global applicability.
The cost-minimal RTUS system was constructed by utilizing a standard off-the-shelf laptop computer that connected to the internet through an internal wireless receiver and/or was tethered through a smartphone. A number of portable hand-held ultrasound devices were digitally streamed into the laptop utilizing a video converter. Both the ultrasound video and the output of a head-mounted video camera were transmitted over freely available Voice Over Internet Protocol (VOIP) software to remote experts who could receive and communicate using any mobile device (computer, tablet, or smartphone) that could access secure VOIP transmissions from the internet.
The RTUS system allowed real-time mentored tele-ultrasound to be conducted from a variety of settings that were inside buildings, outside on mountainsides, and even within aircraft in flight all unified by the simple capability of receiving and transmitting VOIP transmissions. . Numerous types of ultrasound examinations were conducted such as abdominal and thoracic examinations with a variety of users mentored who had previous skills ranging from none to expert. Internet connectivity was rarely a limiting factor, with competing logistical and scheduling demands of the participants predominating.
RTUS examinations can educate and guide point of care clinical providers to enhance their use of ultrasound. The scope of the examinations conducted is limited only by the time available and the criticality of the subject being examined. As internet connectivity will only improve worldwide, future developments need to focus on the human factors to optimize tele-sonographic interactions.
随着技术进步和成本降低，全球范围内超声设备的可及性达到了历史最高水平。要确保患者从超声这种依赖用户操作的技术所带来的更准确复苏和诊断中获益，需要进行准确的检查，这通常需要大量培训。然而，远程远程指导超声（RTUS）检查是空间医学中开创的一种技术，在地球上的适用性不断增加。因此，我们试图创建并展示一种成本最低且具有潜在全球适用性的方法和系统。
成本最低的RTUS系统通过使用一台标准的现成笔记本电脑构建而成，该电脑通过内部无线接收器连接到互联网和/或通过智能手机进行 tethered（此处原文可能有误，推测为“连接”之类的意思）。利用视频转换器将多个便携式手持超声设备以数字方式传输到笔记本电脑中。超声视频和头戴式摄像机的输出通过免费的互联网语音协议（VOIP）软件传输给远程专家，这些专家可以使用任何能够从互联网访问安全VOIP传输的移动设备（计算机、平板电脑或智能手机）接收并进行通信。
RTUS系统允许在各种环境中进行实时指导的远程超声检查，这些环境包括建筑物内、山坡户外，甚至是飞行中的飞机内，所有这些环境都通过接收和传输VOIP传输的简单功能实现了统一。进行了多种类型的超声检查，例如腹部和胸部检查，指导了各种用户，他们之前的技能水平从零基础到专家不等。互联网连接很少成为限制因素，参与者相互竞争的后勤和日程安排需求才是主要限制因素。
RTUS检查可以教育和指导即时护理临床提供者，以增强他们对超声技术的使用。所进行检查的范围仅受可用时间和被检查对象的危急程度限制。随着全球互联网连接只会不断改善，未来的发展需要关注人为因素，以优化远程超声检查的交互。
