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Pointing the Way Forward: Wearable Technology and Point of Care Ultrasound

Jacob Glaser, MD1, Matthew Vasquez, MD2, Cassandra Cardarelli, MD2, Sarah Murthi, MD1. 1University Of Maryland, 2Walter Reed national Military Medical Center

Technology Objective

The miniaturization and improved capability of handheld ultrasound has led to a revolution in the field of point of care (POC) diagnostics. POC ultrasound increased efficiency while decreasing cost and simultaneously improving patient safety and satisfaction. Current handheld ultrasound systems have slowed the learning curve and adoption of ultrasound in surgery and critical care.

Recognizing this gap, a fingertip ultrasound probe has been developed, creating a marriage between wearable technology, portable diagnostics, and ‘heads up’ imaging. Developed for the military, and conceptualized for the pre-hospital and trauma arena, the fingertip ultrasound allows the user to see, feel, and image the patient while keeping both hands free to manage the patient.

Technology Description and Application

The SonicEye® is a wearable ultrasound probe, leveraging innate human hand-eye coordination while providing both fine-motor positional control and spatial awareness of fingertip location with tactile feedback. It is truly wearable, and therefore can be used with current ultrasound systems as well as portable devices, such as Google Glass.

Its first generation- a wired device to a standard ultrasound platform- sets the stage for applications such as guided procedures, intraoperative and breast imaging, as well as improving early diagnosis of traumatic brain injury and intra-abdominal hemorrhage. For prehospital applications it brings ultrasound technology far forward, allowing for immediate identification of injury and improved patient triage.

Results

We introduced the SonicEye® to physicians and nurses at the R Adams Cowley Shock Trauma Center, the busiest stand-alone trauma center in the country. After trialing the device, participants completed a survey. We collected information on user background, ultrasound/procedure experience, ease of use, and image quality across 9 standard ultrasound categories.

Forty five surveys were completed: 23 physicians, 16 nurses, 6 students and 2 ultrasound technicians participated. Experience levels were defined as novice (<20 ultrasound exams, n=15), intermediate (>20<100 exams, n=17) and expert (>100 exams, n=13). Overall results were favorable toward the device across all categories. For peripheral IV placement 88.1% felt that it would be useful, with 82.9% stating that it was the same or better than current technology. For arterial and central access, 79.1% found it useful and 67.6% felt it was the same or better (26.2% undecided). Among expert users, 75.5% felt that this device was the same or better than current standard. The majority of respondents also found it useful or better for thyroid, soft tissue, airway, and pulmonary, and optic nerve applications.

Conclusions

At a high volume trauma center the SonicEye® linear fingertip ultrasound probe was found to be useful across a multitude of common point of care ultrasound applications. Perceptions were overwhelmingly positive, with none reporting a compromise in diagnostic accuracy. Ultrasound will continue to be on the cutting edge of bedside care, and with the development of additional probes, wireless features, and heads up imaging, future applications for this technology will continue to expand. In the far forward arenas of military combat triage, humanitarian medicine, and prehospital care, uses for this device may only be limited by imagination.

82

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