Having scored the first weekend of the year on-call I thought I would take along the new hand held echo machine on my rounds to brighten things up a bit.
We only took delivery of this unit just before Christmas so this was really my first opportunity to put it to use where I think it will be of value; not in the echo lab but out there on the rounds, and primarily in the CCU. In this post I’m just going to cover some of the practical aspects of the device itself and less to do with its clinical impact, which frankly I think is a little early to really assess anyway.
There is going to be a lot of debate, I anticipate, about what the appropriate role of these sort of machines will be and probably even more about who should be using them. Again, in order to avoid courting controversy, I won’t be addressing that here (at least not in this post).
Finally, all these comments relate to the GE VScan – this is not the only machine on the market that could be considered to offer hand held echocardiography, but it’s the only one I’ve used. My comments here are therefore limited to that particular machine but are unbiased and I certainly don’t have any specific conflict of interest in relation to this post.
This really is hand held echocardiography. There is no doubt that this machine offers to provide meaningful clinical information in a truly portable, battery powered unit. It is perhaps this more than anything else that makes this an exciting device.
Somewhere in my memory is a black and white picture of the first echo machine in town and in fact it used to be still sitting in the corner of a research lab where I trained, at least until a few years ago. Imagine a unit about the size of a 19 inch server rack, floor to ceiling, with a circular oscilloscope screen of about 6 inch diameter and you roughly have the idea. I’ve no idea what you could see on the screen but I’m pretty sure it was probably just B mode echoes. Bear in mind that this was in use within the careers of my current senior colleagues and you get some idea of the technological advance that the VScan represents.
Ergonomically, the device is easy to handle and use. The machine powers up on opening the hinged screen, a mechanism which feels robust and should be able to withstand a bit of use. In fact the whole unit, although very light, feels pretty robust – whilst you probably would get a few palpitations if you dropped it on the floor I suspect that it could take a few knocks – reassuring for a device that is clearly designed for use on the ‘front-line’. The transducer is light and feels ‘easy’ in the hand. This together with the very lightweight cable makes imaging pretty easy. It is very feasible, as in the marketing images, to have the transducer in one hand and the machine in the other.
The VScan was demonstrated to me a few months ago and I didn’t have time to look at the manual before taking it out on rounds this weekend. So the fact that I could use it at all is probably the best indication of the user-friendly nature of the device and its controls. I may not have been getting the best from the machine for this reason but the simple tasks that I needed – powering up, initiating a new study, 2D imaging, image capture, freeze frame, colour flow imaging etc -were all self explanatory without any help. It’s pretty obvious that the engineers of the VScan have taken some inspiration from the design of the iPod and the intuitive nature of the interface and controls must also be complimented. In fact, you come away thinking that if Apple designed a portable echo machine it just might….
Boot up and battery
From cold it takes abut 20-30 seconds to boot from sleep to initiating a new study and imaging. That’s pretty much nothing for an ultrasonic unit.
I suspect battery life isn’t that great. After performing just two scans of less than five minutes on a fully charged machine the battery indicator was at around 50%. I’ve no idea what GE quote as battery life but I think if you were really using this as an extension of clinical examination on a lengthy round then it would become an issue. Having a docking station for recharging on the ward would obviously help to solve this.
The VScan archives to a removable memory card and images can be exported to proprietary GE software on a PC but at the moment there is no facility to export DICOM files and therefore no ability to integrate with an established echo PACS system. For that reason, in our lab at least there is no ability to integrate the machine with our existing image-review-report workflow.
The VScan, even in its case, looks and feels so inconsequential that it’s pretty easy to put it down and forget where you’ve put it. I did the several times on a busy round. I recommend that your vigilant fellow/registrar is given the opportunity of making sure you don’t lose the unit and thereby giving you the option of having someone to share the blame when you do.
For this reason, and the fact that this looks like the sort of thing that could be fun at home, I expect the VScan to rapidly rise up the table of equipment items most likely to be stolen from the hospital.
Bear in mind that I am no expert here. These are purely my first impressions, hands on, in the real world. Any corrections or clarifications are most welcome.
Oh, and you need to take some ultrasound gel with you. A space in the bag for a small bottle would be good!
You can find out and see more of the VScan at the GE website at http://vscanultrasound.gehealthcare.com/