Tele-intensivists can instruct non-physicians to acquire high-quality ultrasound images

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...

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Bibliographic Details
Published in:Journal of critical care Vol. 30; no. 5; pp. 871 - 875
Main Authors: Levine, Andrea R., McCurdy, Michael T., Zubrow, Marc T., Papali, Alfred, Mallemat, Haney A., Verceles, Avelino C.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.10.2015
Elsevier Limited
Subjects:
Adult
Bladder
Cameras
Colleges & universities
Confidence intervals
Critical Care
Critical Care - methods
Decision making
Female
Health Personnel - education
Humans
Intensive care
Intensive Care Units
Laboratories
Likert scale
Male
Mortality
Nursing
Physicians
Pilot Projects
Prospective Studies
Remote telementored ultrasound systems
RTMUS
Teaching - methods
Tele-ICU
Tele-intensivist
Tele-ultrasound
Telemedicine - methods
Ultrasonic technology
Ultrasonics - education
Ultrasonics - standards
Ultrasonography - standards
Veins & arteries
Workforce planning
United States > US
Tele-ICU
Tele-ultrasound
RTMUS
Remote telementored ultrasound systems
Tele-intensivist
ISSN:0883-9441, 1557-8615, 1557-8615
Online Access:Get full text
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Summary: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. 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. 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. 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.
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ISSN:0883-9441
1557-8615
1557-8615
DOI:10.1016/j.jcrc.2015.05.030