Portable Ultrasound Machines

The very first portable ultrasound machine was available commercially in the mid 1970s. However, portable ultrasound machines were not widely distributed until the early 1980s, with even more portable, smaller, battery-powered versions arriving on the scene in the late 1990s. The first units to be brought bedside were used by OB/GYN physicians and private practices.
Small handheld units are now available at prices that can be afforded by individual doctors and used as a diagnostic tool during their face-to-face interactions with patients. There are even home handheld units available to the general public.

Portable ultrasound systems, whether carried by hand or wheeled, are used for doing cardiac, vascular, radiology, endocrinology, pediatric, and OB/GYN studies. They are available in 3D and 4D versions. Portable ultrasound machines are particularly useful in settings with limited space or where being mobile is critical. In the field, the portable devices are very helpful for use by military and emergency medical services personnel. It can be used for diagnostic purposes and therapeutic uses like ultrasound-guided pericardiocentesis, as well as:

• abdominal imaging,
• thoracic/cardiac imaging,
• vascular imaging,
• OB/GYN imaging,
• neuroimaging,
• musculoskeletal imaging,
• FAST examination,
• triage, disaster triage,
• support in choice of the appropriate method of transportation and patient destination,
• prevention of unrequired field interventions like needle thoracostomy in case of suspected pneumothorax.

The primary advantage of the portable ultrasound machine is its widespread utility. As you can take the machine to the patient’s bedside and into the field, it is a highly useful tool for making quick diagnoses with confidence and high productivity, as well as sharing images with patients on the spot. If the ultrasound is made by a doctor, a diagnosis could be immediate. In addition, portable machines can easily be relocated as necessary to function in a variety of situations, including technician and lab settings, as well as clinical and hospital settings and pre-hospital phase of care.
In 2013 outcomes of the study “Prehospital chest ultrasound by a dutch helicopter emergency medical service” conducted by Ketelaars et al. was published in Journal of Emergency Medicine. 326 portable US examinations of the chest were performed on 281 patients. The mean duration of a portable US examination was 2.77 (+/-1.30) min, and the duration decreased over time. After the US examination, the plan for treatment changed in 60 patients, for example for 10 patients the plan to place a chest tube was abandoned, for other 10 patients the initially selected hospital destination for definitive care changed (to a lower-level hospital more often than to a higher-level one);for 9 patients a decision to stop cardiopulmonary resuscitation was undertaken. In conclusion, information obtained by administering pre-hospital US aided in foregoing unnecessary invasive interventions and directing patients to the appropriate type of hospital, although further prospective data is needed to provide evidence regarding the value of pre-hospital ultrasound.
A review of studies on portable ultrasound conducted by Rudolph et al. was published in Resuscitation. They confirmed the general trend in the available literature, which suggests that portable ultrasound is a helpful tool in pre-hospital decision making and that it may positively impact diagnosis, treatment and referral and is unlikely to cause harm. Due to Becker’s systematic review published in Tropical Medicine and International Health in 2016 the effect is valid in developing and low-income to middle-income countries as well.

Portable and console ultrasound machines each have their role, and each is valued for its particular function. Portable ultrasound machines are quicker to use and can be useful in doing bedside and field studies, but they should not be relied upon to completely replace a full ultrasound examination. Their convenience and ease, particularly when the doctor is doing the exam and is there to be questioned in person at the time of the ultrasound exam, is an added benefit of the portable units. And their use in the field by military and emergency medical personnel is inarguably lifesaving. Often portable ultrasound machines are used as a first step to a more full scale ultrasound examination by a trained technician.
Based on the study conducted by Tse, Luk and Lam in 2014, pocket-sized ultrasound machines are comparable to their stationary verisions for detecting a number of abdominal pathologies (fe. hydronephrosis, gallstones, intrahepatic ductal stones, intra-abdominal collection, major vessel abnormality and fluid collection) Its satisfactory imaging ability is due to the high-contrast resolution difference of abdominal organs on ultrasonography. Therefore, portable ultrasound machines can be useful in acute settings.
Major barriers to the adoption of portable ultrasound include cost, training requirements, and lack of evidence for improvement in patient-related outcomes (e.g., morbidity and mortality)