Vital Times 2022 - 63

ENGINEERING AND TECHNOLOGY
Hands-on with Portable
Ultrasound Devices
in Developing Nations
Craig Belon, MD, PhD
" I don't know, Clint,
you think that thing
will even turn on? "
Buried deep in the corner
of the supply closet
we had discovered
a Volkswagen sized
ultrasound machine.
The instrument itself looked like it weighed a ton
and would not have been out of place in the missile
control room of a Regan-era cold war film. We
plugged the machine in and waited an agonizing 20
minutes for it to boot up. The next obstacle was
negotiating the Spanish-language menus and, finally,
we were treated to a grainy ultrasound image capable
of guiding our PECS block. I suspected this was the
first ultrasound guided regional anesthetic performed
on an adolescent in our small rural hospital deep in
Guatemala. I cynically suggested we may be using
the actual first ultrasound machine ever invented.
We only performed two ultrasound guided regional
anesthetics (USGRA) on children that year, 2019.
Despite the success, unplugging the machine to move
it to another OR meant waiting for it to come online for
far too long to be of any real practical use. Our pediatric
patients were there for general surgical procedures,
mostly ventral, umbilical or inguinal hernia repairs and,
as such usually got caudal epidural anesthesia. On my
list that week, 19 of the 23 patients got caudals, typical
for each of the four of anesthesiologist that year, and
the years prior as well. Despite the incredibly long track
record of safety for caudal anesthesia, the looming
threat of local anesthetic systemic toxicity (LAST) was
palpable. In a resource poor environment with limited
access to intralipid rescue and nonexistent critical
care, any effort to decrease that risk would be huge for
patient safety.
Meanwhile, back in the United States, ultrasound
technology had rapidly advanced. Starting in about
2018, vendors at meetings began demonstrating
incredible new handheld devices, vaguely reminiscent
of tricorders from Star Trek. The designs were simple:
a probe on a cord with a small screen, either dedicated
hardware or the ability to plug into a smartphone
or tablet, depending on manufacturer. Instead of
Annual Publication 2022 | 63

Vital Times 2022

Table of Contents for the Digital Edition of Vital Times 2022

Vital Times 2022 - Cover1
Vital Times 2022 - Cover2
Vital Times 2022 - 1
Vital Times 2022 - 2
Vital Times 2022 - 3
Vital Times 2022 - 4
Vital Times 2022 - 5
Vital Times 2022 - 6
Vital Times 2022 - 7
Vital Times 2022 - 8
Vital Times 2022 - 9
Vital Times 2022 - 10
Vital Times 2022 - 11
Vital Times 2022 - 12
Vital Times 2022 - 13
Vital Times 2022 - 14
Vital Times 2022 - 15
Vital Times 2022 - 16
Vital Times 2022 - 17
Vital Times 2022 - 18
Vital Times 2022 - 19
Vital Times 2022 - 20
Vital Times 2022 - 21
Vital Times 2022 - 22
Vital Times 2022 - 23
Vital Times 2022 - 24
Vital Times 2022 - 25
Vital Times 2022 - 26
Vital Times 2022 - 27
Vital Times 2022 - 28
Vital Times 2022 - 29
Vital Times 2022 - 30
Vital Times 2022 - 31
Vital Times 2022 - 32
Vital Times 2022 - 33
Vital Times 2022 - 34
Vital Times 2022 - 35
Vital Times 2022 - 36
Vital Times 2022 - 37
Vital Times 2022 - 38
Vital Times 2022 - 39
Vital Times 2022 - 40
Vital Times 2022 - 41
Vital Times 2022 - 42
Vital Times 2022 - 43
Vital Times 2022 - 44
Vital Times 2022 - 45
Vital Times 2022 - 46
Vital Times 2022 - 47
Vital Times 2022 - 48
Vital Times 2022 - 49
Vital Times 2022 - 50
Vital Times 2022 - 51
Vital Times 2022 - 52
Vital Times 2022 - 53
Vital Times 2022 - 54
Vital Times 2022 - 55
Vital Times 2022 - 56
Vital Times 2022 - 57
Vital Times 2022 - 58
Vital Times 2022 - 59
Vital Times 2022 - 60
Vital Times 2022 - 61
Vital Times 2022 - 62
Vital Times 2022 - 63
Vital Times 2022 - 64
Vital Times 2022 - 65
Vital Times 2022 - 66
Vital Times 2022 - 67
Vital Times 2022 - 68
Vital Times 2022 - 69
Vital Times 2022 - 70
Vital Times 2022 - 71
Vital Times 2022 - 72
Vital Times 2022 - 73
Vital Times 2022 - 74
Vital Times 2022 - 75
Vital Times 2022 - 76
Vital Times 2022 - 77
Vital Times 2022 - 78
Vital Times 2022 - 79
Vital Times 2022 - 80
Vital Times 2022 - 81
Vital Times 2022 - 82
Vital Times 2022 - 83
Vital Times 2022 - 84
Vital Times 2022 - 85
Vital Times 2022 - 86
Vital Times 2022 - 87
Vital Times 2022 - 88
Vital Times 2022 - 89
Vital Times 2022 - 90
Vital Times 2022 - 91
Vital Times 2022 - 92
Vital Times 2022 - 93
Vital Times 2022 - 94
Vital Times 2022 - 95
Vital Times 2022 - 96
Vital Times 2022 - 97
Vital Times 2022 - 98
Vital Times 2022 - 99
Vital Times 2022 - 100
Vital Times 2022 - 101
Vital Times 2022 - 102
Vital Times 2022 - 103
Vital Times 2022 - 104
Vital Times 2022 - Cover3
Vital Times 2022 - Cover4
https://www.nxtbook.com/allen/csvt/vital-times-2022
https://www.nxtbook.com/allen/csvt/vital-times-2021
https://www.nxtbook.com/allen/csvt/2020
https://www.nxtbook.com/allen/csvt/2019
https://www.nxtbook.com/allen/csvt/2018
https://www.nxtbook.com/allen/csvt/2017
https://www.nxtbook.com/allen/csvt/2016
https://www.nxtbook.com/allen/csvt/2015
https://www.nxtbook.com/allen/csvt/2014
https://www.nxtbookmedia.com