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Customer Story: Mediphan goes to Mount Everest
Remote Ultrasound Under Extreme Conditions on Mt. Everest
Mountaineers face a variety of health risks at altitude including pulmonary edema; portable ultrasound may be used to diagnose high altitude pulmonary edema. However, no radiologists are available during Mt Everest expeditions, meaning electronic equipment in a hypobaric test environment must be used in order to allow remotely guided nonexperts to use ultrasound to evaluate respiratory status on Mt Everest.
Two GE LOGIQ e ultrasound devices and associated video equipment were tested in a cooled (4uC–5uC) hypobaric chamber to 27 000 feet (8230 m) before travel to Mt Everest. The ultrasound system was connected to the Mediphan DistanceDoc remote guidance and broadcasting device. Via satellite link through a satellite phone, DistanceDoc was also connected to the Internet. This allowed the guidance of a novice user by an expert. Pulmonary interstitial fluid was quantified by the presence of ‘‘comet tail’’ artifacts.
A commercially available, high-fidelity, portable ultrasound system GE LOGIQ e from General Electric Medical and a prototype solid state system equipped with a 12-5 linear probe were used for the ultrasound investigations. The super video graphics array (SVGA) output of the ultrasound system was fed to the Mediphan DistanceDoc medical video streaming device to digitize and compress the video signal. The DistanceDoc USB output was coupled to a portable computer for streaming through the Ethernet connection to secure, remote viewing sites over a satellite phone link-up.
There was no notable degradation in equipment performance in cold, hypobaric conditions; ultrasound confirmation of increased comet tails was noted in the chamber despite oxygen supplementation and the very brief exposure. With the aid of Mediphan DistanceDoc, two pulmonary surveys of asymptomatic participants were completed by novice operators within 25 minutes on Mt Everest. The remote expert was able to guide and identify comet tails suggestive of intermediate pulmonary interstitial fluid. Image quality was excellent.
The tested ultrasound devices functioned nominally in cold, hypobaric conditions; acute changes in lung fluid content were noted in these conditions despite normoxia. A satellite telemedical connection was successfully used with a remote expert to guide thoracic ultrasound examinations at Advanced Base Camp on Mt Everest. Coupling portable ultrasound with Mediphan DistanceDoc, remote expert guidance telemedicine provides a robust diagnostic capability in austere locations. Guided by an expert via phone, using ultrasound equipment from GE and remote guidance equipment from Mediphan, members of the expedition were able to effectively perform ultrasound diagnosis in extreme conditions and without any specialized training.
The original case study used to write this article can be found here: http://www.ncbi.nlm.nih.gov/pubmed/19737030
Take a look at an early dry run BETA test in the video below