The image of a doctor with a stethoscope around his or her neck is deeply ingrained in everyone’s mind, so much so that anybody with a white coat and a stethoscope is thought to be a doctor. The stethoscope has been used for over two centuries by doctors to check all kinds of sounds within the body, including those emanating from the heart, lungs and even stomach. In fact, the stethoscope is an important primary diagnostic tool in the hands of a competent doctor. It is only when the sounds are clinically co-related with the medical history and symptoms of the patient that a doctor may ask for more advanced medical tests, if necessary.
A portable ultrasound machine
Science, technology and modern medicine combined with miniaturization may well make the small portable ultrasound machine the ‘stethoscope’ of the 21st century. Ultrasound machines are typically used in labs, hospitals and doctors’ offices to diagnose many ailments, offering a more direct inner view of the body. They are non-invasive and use sound waves to generate a picture of soft tissues in the body. They are routinely used for women whether during pregnancy or as a primary diagnostic tool for fibroids, cysts, ovulation cycles and for both genders for many other ailments concerning the heart, liver, kidney, gall bladder, muscles, tissues, ligaments, glands and even eyes.
Though small ultrasound machines that are portable are available, they have to be used by trained radiologists and the machines are only smaller versions of the larger ones, used during emergencies, when it may be risky to move the patient.
Hand held ultrasound machines
The new ultrasound machines are actually hand held, similar in size to a deck of playing cards. They are not going to be available sometime in the future – they are already in the market. Among the many companies manufacturing these lightweight ultrasound machines are:
Konica Minolta – Sonimage P3 provides high quality images that can be viewed both on the device or in larger sizes and better clarity when the device is plugged into a PC, laptop or tablet. It weighs less than 14 oz.
Mobisante Ultrasound – MobiUS SP1 is less than 12 oz, comes with a viewer, is about the size of a smartphone, works likes one (without the calling facility) and can send the data wirelessly to people or to other devices for diagnostic purposes, to store the images and data and keep records. Like a smartphone, it has a touchscreen user interface.
GE Healthcare – Vscan is their portable ultrasound device with a one-hand user interface, making it ultraportable and easy to use. One of the earliest ones to come into the market, the Vscan provides high quality images for faster diagnosis.
There are other companies, too, making similar machines or slightly larger ones. Most of them work on batteries and can work for an hour without needing a recharge. They also come with docking stations and accessories and most can take memory cards.
How effective are these hand held machines?
Obviously these machines cannot provide the superior quality and depth of images that larger machines do. But because they are so convenient to use and can easily become the primary diagnostic tool, they work very well in emergency situations and can diagnose conditions faster that otherwise may take another round of investigations. Using these smaller devices can reduce the need for diagnosis by larger machines that cost the patient or insurance company a great deal of money, adding to healthcare costs.
One major roadblock in their widespread usage is that while stethoscopes are easy to use, doctors may require special training with these devices to be able to provide an accurate diagnosis. On the plus side, as medical students come into contact with these new devices they will be able to work with them more easily.
According to an editorial How Relevant is Point-of-Care Ultrasound in LMIC authored by Dr. Jagat Narula, associate dean for global affairs at Mount Sinai School of Medicine in New York, and Dr. Bret Nelson, associate professor of emergency medicine at Mount Sinai, in the December 2103 issue of Global Heart, stethoscopes are on their way out and being replaced by portable ultrasound devices to provide a quicker and more accurate diagnosis in the hands of doctors. These devices could help prevent misdiagnoses and detect abnormalities that can lead to quicker intervention.
However, some doctors, particularly the older and more traditional ones may not give up the stethoscopes so easily. Many of them are attached to them in different ways. Let us not forget that these analogue devices do not need batteries, screens and other paraphernalia that go with portable ultrasound devices – they just need trained and experienced human ears.
National Institutes of Health