Emergency Ultrasound Section Forum
Ultrasound and Simulation
The following summary of Ultrasound Simulation Equipment is taken from the ACEP US Feb 2012 Newsletter, Technical Updates Section, at http://www.acep.org/Content.aspx?id=83784 written by Laleh Gharahbaghian, Zoe Howard, and Greg Bell. Please add or comment with your experiences so we can share with the EUS community!
Blue Phantom’s FAST Exam Real-Time Training Model
As one of the most popular manufacturers of ultrasound (US) simulation phantoms, Blue Phantom offers a new simulation tool that is promised to enhance US education of the FAST and TTE scans. It also can function as a pericardiocentesis training model. This human-looking head to thigh model is constructed using Blue Phantom’s patented simulated human tissue. By users utilizing their own US system, this 25K phantom offers the ability to visualize the thorax, abdomen and pelvis while encountering obstacles that we all must overcome: applying enough pressure for visualization, bowel gas and ribs obstructing the view. Adjustable internal bleeding levels allow users to individually vary the training scenarios based on the scenarios being presented.
The VIMEDIX TTE and FAST human appearing head to thigh simulator offers an ability to visualize the thorax, abdomen and pelvis using the VIMEDIX’s transducer that is attached to their computerized control monitor. This is a virtual ultrasound TEE, TTE and FAST simulator without fluid filled structures inside. It allows the ability to visualize, on a split screen, varying layers of surrounding anatomy on one side of the monitor and the ultrasound image on the other. It allows M mode, color and pulsed wave Doppler, 3D animated augmented reality, and then ability to adjust gain and depth.
MedSim’s UltraSim offers an excellent simulator for ultrasound educational training. Its hefty price tag (~$100k) includes a full-size training mannequin with simulator probes that communicate with the UltraSim computer. B-mode, Color and Spectral Doppler modes are all available. The computer houses both normal and abnormal stored images of real patient ultrasound data in diverse disease pathologies.
A highlight is the comprehensive educational component offered by way of its broad selection of modules (Abdomen, Obstetrics, Gynecology, Transvaginal Gynecology, Transvaginal Obstetrics, Breast, Vascular, Neck and Emergency Medicine). Within each module is a curriculum of clinical cases, each with a detailed patient presentation, task list to help guide the learner, image library and case analysis with additional features to enhance the instructor’s evaluation or competency assessment/accreditation. Overall, it is a realistic hands-on ultrasound scanning experience worth checking out!
The SonoMan and SonoMom are the two main teaching ultrasound simulators that Simulab offers. The body form has imbedded targets (258 in the Man and 148 in the Mom) which provide actual patient images. Each of these targets provide images in a transverse and longitudinal plane and a video clip showing the technique for scanning that area. For each normal scan there are five abnormal images depicting the common pathologies that EM residents need to know. An instructor mode provides annotated images to describe what is being seen and important landmarks. The student mode picks normal or abnormal images randomly according to the study application. The SonoMan has six modules including FAST, ECHO, Gallbladder, AAA, and Renal and EFAST which are each sold separately. The SonoMom comes with a 1st trimester module for transabdominal and transvaginal imaging. Both systems come with a tissue-like body core, software which is updated for free with purchase, the probe and a carrying case. The SonoMan is going for $5450 with an expected purchase of at least one module. Modules range from $1050 to $1950. The SonoMom is $6950 and the 1st trimester module is $1950. Simulab always provides special offers with purchases, listed on their website, including such things as a free module when another is being purchased.
Though these are not dynamic teaching simulators, they are relatively inexpensive and are good teaching tools especially for the starting resident to teach image acquisition, landmarks, and some pathology.
SonoSim Ultrasound Training Solution
The SonoSim product is a unique learning tool for the money. Their intention was not to create a simulator, but an integrated tool linking interactive multimedia-based teaching with hands-on dynamic training. The designers intend this to be a near complete introduction to the EM ultrasound curriculum, except for instructor supervision and fine detail learning that takes place at the patient’s bedside. Each of 10 modules covering all of the emergency or critical care applications are taught in two hours of still and dynamic ultrasound imagery, audio narration, computer graphics, and animation. Over 400 questions assess the learners grasp of this material. The SonoSim fixed-point probe is designed to respond to subtle directional movements and to create dynamic real patient images. 150 real patient cases depict an array of normal and pathologic cases. The SonoSim product includes the PC housing the software and the probe for $15,000. The material is updated and expanded continually and these additions are provided free for one year following purchase. SonoSim will soon be offering 20 hours of CME through ACEP for successful completion of all the modules. For a much lower price than some other products the SonoSim teaching tool appears to emphasize well refined multimedia teaching with real patient dynamic scanning; linking the two together to optimize efficient, realistic and comprehensive learning.