In this MEDICA-tradefair.com interview, Dr. Achim Ehrt explains situations where POCUS is especially helpful, describes the latest innovations in this area, and predicts the future of this technology.
Dr. Ehrt, when is the use of point-of-care ultrasound (POCUS) necessary?
Dr. Achim Ehrt: First, we need to distinguish between the use of this imaging modality in clinical and preclinical settings. When it comes to clinical use, POCUS is a common approach in the intensive care unit, in clinical anesthesia and in emergency medicine, because it answers many clinical questions or guides a procedure quickly at bedside and eliminates long patient transport.
It is somewhat more difficult to substantiate its importance in preclinical scenarios: The question here is always whether its application may contribute to delays since onsite ultrasound may waste precious time or whether it is particularly relevant to the treatment of the patient. For example, a preclinical ultrasound is a time waster if a patient is transported to the nearest tertiary care hospital after a traffic accident anyway.
That being said, I believe POCUS is of utmost importance in patients with life-threatening conditions, because the device quickly delivers answers to questions that used to require extensive diagnostic exams (CT, X-Ray imaging).
Why is POCUS becoming more and more significant?
Ehrt: I think the main reason its reach is increasing is because the devices are getting smaller, better, more adaptable, and more powerful with premium image quality. An ultrasound machine used to be as big as a refrigerator, sat in the ultrasound laboratory and could not be moved. Today's devices are portable and compact with battery power that allows forty-five minutes of continuous scanning.
The latest innovation is an ultrasound transducer that is connected to a smartphone or tablet, making it portable like a stethoscope. In my opinion, this is the key why POCUS has been increasingly adopted by a wide variety of users: the devices are more accessible and increasingly affordable, allowing even smaller hospitals to purchase them, which increases the number of people who get training to use them. One thing leads to another: the more people become fans of this technology, the more devices are being purchased. And the more devices are being purchased, the more people seek training and education – creating a beautiful perpetual cycle.
Do you need a different technology than the one that is already present at hospitals or do you just need new equipment?
Ehrt: The technology is the same, but it is getting more and more compact, with devices getting smaller and handier thanks to very powerful chips. This marks the end of the old-fashioned refrigerator-sized ultrasound units. The ultrasound transducers still convert electrical energy into mechanical (sound) energy and back again, based on the piezoelectric effect.
One company has now developed an innovative ultrasound transducer that generates the sound waves via the circuit board so that you can simulate different types of transducers with a single transducer platform. If this technology takes off and works as well as recent tests suggest, it is set to revolutionize ultrasound practice again, because the device will then only need one transducer versus the three common ones popular POCUS tools require today.