Ultrasound and satellite technologies bring live cardiac images from field to hospital in Texas

Orlando 10 June 2002At the American Society of Echocardiography's 13th Annual Scientific Sessions, doctors from the Brooke Army Medical Center at Fort Sam Houston and engineers from the Southwest Research Institute in San Antonio presented new research with regard to the wireless and remote transmission of live ultrasound images from the field to the hospital. This diagnostic technique is a new use of telemedicine to assist in medical diagnosis and treatment during a mass casualty situation.

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For the first time, doctors in Texas transmitted live echocardiograms, images of the heart and vessels, of patients from moving ambulances to emergency rooms for evaluation ahead of the patient's arrival to the hospital. Two-way voice and data communications allowed reviewing cardiologists to remotely direct the examinations from as far away as 20 miles while ambulances were travelling an average of 62 miles per hour.

"The ability to triage patients before they arrive at the hospital will greatly improve the delivery of patient care, and has particular significance to overburdened emergency rooms and to metropolitan areas clogged with traffic", stated Paul D. Garrett, M.D., lead author of the study. "Every second counts when dealing with trauma patients. This breakthrough technique will save time and, more importantly, lives."

The research team of physicians and engineers used small handheld ultrasound units configured to transmit 2D images of the patients' hearts and vessels from ambulances. Images were transmitted to the hospital using the existing metropolitan traffic management fibre optic network, broadband radio technology and video compression techniques.

"Echocardiography is the most widely used imaging technique to diagnose a variety of cardiovascular disorders", stated Randolph P. Martin, M.D., vice president of the American Society of Echocardiography. "By making an existing diagnostic tool live, remote and mobile, researchers have stepped into the future of telemedicine."

Army doctors also recently tested the feasibility of using echocardiography with portable satellite equipment in a remote location to transmit live images back to hospital-based cardiologists. Researchers were pleased with the ability to accurately diagnose and prioritise treatment of patients in real time for major cardiac abnormalities from the field.

In a crisis with multiple casualties, 25 to 50 percent of all traumatic deaths are related to chest injury. A majority of these injuries are caused by blunt or penetrating cardiac and aortic injuries. The Army doctors evaluated innovative applications of both ultrasound and satellite technologies to take the specialists to the field.

"There are not enough cardiologists to serve on the scene of a mass casualty situation", explained Sheri Boyd, M.D., a researcher involved in the study. "Remote use of echocardiography is kind of a medical force multiplier. If we can move this technology up to the front line to aid in early diagnosis, it will help our troops in combat as well as civilians in a mass casualty scenario."

In San Antonio, Texas, researchers based at Fort Sam Houston's Brooke Army Medical Center, simulated a crisis in a remote location. Sonographers used handheld ultrasound units to record images of cardiac patients' hearts and vessels. The sonographers wore custom-made vests with transmitters which sent live images to the hospital via a portable satellite dish set up on site.

Cardiologists stationed in the hospital remotely directed examinations via satellite and two-way communication to diagnose the patients. To gauge technical quality and diagnostic accuracy, the new images were compared with those captured prior to the exercise in the hospital from the same patients.

"We were broadcasting images to the hospital from 40 miles away, but given the same technology it could have been as far as 400 or 4000 miles", stated Dr. Boyd. "This technology could have immediate application for our troops abroad and for humanitarian missions." The Brooke Army Medical Center is one of the lead agencies developing and testing pioneering applications of echocardiography for crisis use. The research was funded through a military telemedicine grant.

The American Society of Echocardiography (ASE) Scientific Sessions serve as a showcase for new advances and research in cardiovascular medicine. The four-day programme includes invited lecturers, symposia and manufacturers' exhibits. Featured speakers include national and international leaders and teachers in the field of echocardiography and cardiology.

Based in Raleigh, North Carolina, the American Society of Echocardiography is a professional organisation of physicians, cardiac sonographers, nurses and scientists involved in echocardiography, the use of ultrasound to image the heart and cardiovascular system. The organisation was founded in 1975 and has more than 7000 members nationally and internationally.


Leslie Versweyveld

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