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Point-of-Care Ultrasound System Complements Radiology Services

By MedImaging International staff writers
Posted on 11 Feb 2009

An ever-increasing number of radiologists are looking closely at point-of-care ultrasound to complement traditional radiology services. Used for specific applications and situations, point-of-care scanning allows routine scanning to be performed throughout the hospital by trained non-radiology staff, while freeing up time for sonographers to focus on specialist services.

Dr. Simon Elliott, consultant radiologist and clinical lead in ultrasound at the Freeman Hospital (Newcastle, UK), explained how his own radiology department is making use of hand-carried ultrasound systems, "We have been using portable ultrasound since we evaluated the UK's first SonoSite (Bothell, WA, USA) 180PLUS point-of-care system in 1999. We were very happy with the versatility and image quality of that system for the vast majority of our portable workload, and since then, use of point-of-care ultrasound has dramatically expanded in the hospital. We have now used a full range of systems, simpler ones used on the wards for vascular access and abdominal scans, and some of the more sophisticated and up-to-date models, like SonoSite's MicroMaxx system, in specialist areas such as critical care and the transplant units. We recently reviewed the newest M-Turbo system; it has very good color sensitivity and you really can just open it up and start scanning straight away. It was universally very well received.”

Dr. Elliott reported that the hospital began training consultants to conduct scans within their area of expertise, and this soon increased to a range of ward staff, creating a large skill base for basic scanning procedures. Dr. Elliott added, "there are governance rules and audit procedures in place to ensure that patients receive the best possible service, and new guidelines on the use of ultrasound will help to strengthen this process. Transferring routine work out of the radiology department is a rational use of resources, and releases sonographers and equipment for more specialized scanning. In addition, Sonographers often can make use of the point-of-care systems on the wards for performing complex procedures, such as transplant Doppler or DVT [deep vein thrombosis] scans, and this further eases the workload within the radiology department.”

Recently, according to Dr. Elliot, the focus of point-of-care ultrasound has been moving away from radiology as a primary market; however, he believes this is now gradually changing. "More radiologists are seeing a role for hand-carried systems in their patient care strategies. The instruments themselves are very robust, which is important in a hospital environment where reliability is crucial, and you can quickly move around the hospital, without having to wait for lifts or move patients. Most importantly, patients are getting a more efficient service, and being able to provide almost instantaneous diagnosis at the bedside is an important way of streamlining hospital resources,” said Dr. Elliot.

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64 (69.141387939453): select jos_twitters.link from jos_twitters where cat=10

65 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

66 (32.901763916016): select jos_google_plus.link from jos_google_plus where cat=10

67 (30.040740966797): select jos_linkedin.link from jos_linkedin where cat=10

68 (38.862228393555): SELECT fid FROM jos_deeppockets WHERE id=294722015 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294722015 AND published='1' LIMIT 1

69 (34.093856811523): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=214 ORDER BY `ordering`

70 (339.98489379883): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722015 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (251.05476379395): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722015 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (45.061111450195): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (52.213668823242): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722015 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.994415283203): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722015 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (33.140182495117): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (64.13459777832): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

105 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

106 (51.021575927734): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294722015 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (44.822692871094): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294722015 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

109 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

110 (49.114227294922): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294722015 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (510.21575927734): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294722015 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (574.11193847656): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (327.11029052734): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

115 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

116 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

117 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

118 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

119 (35.04753112793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

120 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

121 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

122 (269.17457580566): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 19598.007202148): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (595.0927734375): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722015 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722015 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 8876.0852813721): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (97.036361694336): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (38.862228393555): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (46.968460083008): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (303.98368835449): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (48.160552978516): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (32.901763916016): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (523.80561828613): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (338.07754516602): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (233.88862609863): SELECT name FROM jos_deeppockets WHERE id=214

138 (34.093856811523): SELECT name FROM jos_deeppockets WHERE id=214

139 (519.99092102051): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (527.14347839355): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

142 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

143 (!!!!! 9171.0090637207): TRUNCATE TABLE jos_trademed_module

144 (248.19374084473): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294722015 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (71.048736572266): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294722015 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (754.11796569824): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (65.803527832031): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

149 (63.180923461914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

150 (!!!!! 1508.9511871338): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

152 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

153 (41.961669921875): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722015 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722015 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (36.001205444336): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=214 or channel_id is null)

155 (31.948089599609): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=214 or channel_id is null)

156 (34.093856811523): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

158 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722015 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722015 AND published='1' LIMIT 1

159 (36.954879760742): select jos_twitters.link from jos_twitters where cat=10

160 (32.186508178711): select jos_facebook.link from jos_facebook where cat=10

161 (32.186508178711): select jos_google_plus.link from jos_google_plus where cat=10

162 (32.901763916016): select jos_linkedin.link from jos_linkedin where cat=10

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