Entwicklungen, Herausforderung und Perspektiven des Handheld-Ultraschalls (HHUS)

Christoph F. Dietrich; Peter Bulla; Heiko Dudwiesus; Hendra Lo; Michael Hocke; Beatrice Hoffmann; Rudolf Horn; Beat Lehmann; Susanne Morf; Dieter Nuernberg; Helmut Prosch; Andreas Serra; Jörg Spengler; Andrea Blaskova; Christian Jenssen

doi:10.1055/a-1901-9394

Zeitschrift für Gastroenterologie, Inhaltsverzeichnis

Z Gastroenterol 2023; 61(07): 836-851
DOI: 10.1055/a-1901-9394

Übersicht

Entwicklungen, Herausforderung und Perspektiven des Handheld-Ultraschalls (HHUS)

Perspectives and Challenges of hand-held Ultrasound

Christoph F. Dietrich

¹Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland

,

Peter Bulla

²Medizinische Klinik I, Klinik für Gastroenterologie, Gastrointestinale Onkologie, Hepatologie, Infektiologie und Geriatrie, Universitätsklinikum Tübingen, Deutschland, Tübingen, Germany

,

Heiko Dudwiesus

³Sonodiaktika, Langenfeld, Germany

,

Hendra Lo

⁴Brandenburgisches Institut für Klinischen Ultraschall, Medizinische Hochschule Brandenburg, Neuruppin, Germany (Ringgold ID: RIN477107)

,

Michael Hocke

⁵Klinik für Innere Medizin II, HELIOS Klinikum Meiningen, Meiningen, Germany (Ringgold ID: RIN40650)

,

Beatrice Hoffmann

⁶Beth Israel Deaconess Medical Center, Boston MA, Boston, United States

,

Rudolf Horn

⁷Center da sandà Val Müstair, Sta. Maria, Switzerland

,

Beat Lehmann

⁸Universitäres Notfallzentrum, Inselspital Universitätsspital Bern, Bern, Switzerland (Ringgold ID: RIN27252)

,

Susanne Morf

⁹Center da sandà Val Müstair, Sta. Maria, Val Müstair, Switzerland

,

Dieter Nuernberg

¹⁰Brandenburgisches Institut für Klinischen Ultraschall und Fakultät Gesundheitswissenschaften, Medizinische Hochschule Brandenburg, Neuruppin, Germany

,

Helmut Prosch

¹¹Univ. Klinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Wien, Austria (Ringgold ID: RIN27271)

,

Andreas Serra

¹²Hirslanden Klinik Hirslanden, Zurich, Switzerland (Ringgold ID: RIN30364)

,

Jörg Spengler

¹³Internistische Hausarztpraxis, Stralsund, Germany

,

Andrea Blaskova

¹Department Allgemeine Innere Medizin (DAIM), Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland

,

Christian Jenssen

⁴Brandenburgisches Institut für Klinischen Ultraschall, Medizinische Hochschule Brandenburg, Neuruppin, Germany (Ringgold ID: RIN477107)

¹⁴Innere Medizin, Krankenhaus Märkisch Oderland GmbH, Strausberg, Germany

› Institutsangaben

Abstract

Zusammenfassung

Es wird der Einsatz von Handheld-Ultraschallgeräten unter technischen und datenschutzrechtlichen Gesichtspunkten, Geräteeigenschaften, Funktionalität, Dokumentation, Indikationen, Delegation der Leistung, Anwendungen durch Ärzte, Studierende und nichtärztliches Personal beleuchtet und diskutiert.

Abstract

The use of handheld ultrasound devices from a technical and data protection point of view, device properties, functionality, documentation, indications, delegation of performance, applications by doctors, students and non-medical staff is examined and discussed.

Schlüsselwörter

Point of Care - Handultraschall - Palliativmedizin - Notfallmedizin - Leitlinie

Keywords

Point of care - hand held ultrasound - palliative care - emergency medicine - guideline

Volltext

Referenzen

Literatur
1 Ligtvoet C, Rijsterborgh H, Kappen L. et al. Real time ultrasonic imaging with a hand-held scanner. Part I--technical description. Ultrasound Med Biol 1978; 4: 91-92
2 Roelandt J, Bom K, Hugenholtz PG. The ultrasound cardioscope: a hand-held scanner for real-time cardiac imaging. J Clin Ultrasound 1980; 8: 221-225
3 Roelandt J, Wladimiroff JW, Baars AM. Ultrasonic real time imaging with a hand-held-scanner. Part II--initial clinical experience. Ultrasound Med Biol 1978; 4: 93-97
4 Henriksson L, Marsal K. Bedside ultrasound diagnosis of residual urine volume. Arch Gynecol 1982; 231: 129-133
5 Gussenhoven WJ, Kappen L, Ligtvoet CM. et al. Clinical evaluation of a hand-help ultrasound device in pediatric cardiology. Ultrasound Med Biol 1980; 6: 271-277
6 EFSUMB. Birth of “Echoscopy”-The EFSUMB Point of View. Ultraschall in Medizin 2013; 34: 92
7 Moore CL, Copel JA. Point-of-care ultrasonography. N Engl J Med 2011; 364: 749-757
8 Campbell JrEW, Lynn CK. The Physical Examination. In: Walker HK, Hall WD, Hurst JW. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed.
9 Nielsen MB, Cantisani V, Sidhu PS. et al. The Use of Handheld Ultrasound Devices – An EFSUMB Position Paper. Ultraschall Med 2019; 40: 30-39
10 Gesetz über Medizinprodukte Medizinproduktegesetz. 2021 https://www.bundesgesundheitsministerium.de/fileadmin/Dateien/3_Downloads/Gesetze_und_Verordnungen/GuV/M/Medizinproduktegesetz_bf.pdf
11 TuvSud.com. Weiterreichende Änderungen für Hersteller von Medizinprodukten. 2021 https://www.tuvsud.com/de-de/branchen/gesundheit-und-medizintechnik/marktzulassung-und-zertifizierung-von-medizinprodukten/mdrmedizinprodukteverordnungeu#:~:text=Die%20neue%20EUMedizinprodukteverordnung%20%28MDR%29%20ersetzt%20die%20aktuelle%20Medizinpro;
12 Pallidoc.de. Software für die palliative Versorgung. 2021 https://www.pallidoc.de/
13 Swissmedic.ch. Neue Medizinprodukte-Regulierung. 2021 https://www.swissmedic.ch/swissmedic/de/home/medizinprodukte/neue-eu-verordnungen-mdr-ivdr.html
14 Nürnberg D, Esfahani AH, Boten D. et al. Sono-Teleconsulting (USTeleCon) – update 2019. Ultraschall Med 2019; 40: S54 (Suppl. 01)
15 Harris S. Ultrasound Equipment – World Market Report – 2021 Edition, 4. ed. Cranfield: Signify Research; 2021
16 Cardim N, Dalen H, Voigt JU. et al. The use of handheld ultrasound devices: a position statement of the European Association of Cardiovascular Imaging (2018 update). Eur Heart J Cardiovasc Imaging 2019; 20: 245-252
17 Filipiak-Strzecka D, Kasprzak JD, Lipiec P. Brief cardiovascular imaging with pocket-size ultrasound devices improves the accuracy of the initial assessment of suspected pulmonary embolism. Int J Cardiovasc Imaging 2018; 34: 1595-1605
18 Mancuso FJ, Siqueira VN, Moises VA. et al. Focused cardiac ultrasound using a pocket-size device in the emergency room. Arq Bras Cardiol 2014; 103: 530-537
19 Nielsen MB, Cantisani V, Sidhu PS. et al. The Use of Handheld Ultrasound Devices – An EFSUMB Position Paper. Ultraschall Med 2019; 40: e1
20 Dewar ZE, Wu J, Hughes H. et al. A comparison of handheld ultrasound versus traditional ultrasound for acquisition of RUSH views in healthy volunteers. J Am Coll Emerg Physicians Open 2020; 1: 1320-1325
21 Hellgren R, Dickman P, Leifland K. et al. Comparison of handheld ultrasound and automated breast ultrasound in women recalled after mammography screening. Acta Radiol 2017; 58: 515-520
22 An YY, Kim SH, Kang BJ. The image quality and lesion characterization of breast using automated whole-breast ultrasound: A comparison with handheld ultrasound. Eur J Radiol 2015; 84: 1232-1235
23 Bollard SM, Kelly B, McDermott C. et al. The Use of Point of Care Ultrasound in Hand Surgery. J Hand Surg Am 2021;
24 Jackson SS, Le HM, Kerkhof DL. et al. Point-of-Care Ultrasound, the New Musculoskeletal Physical Examination. Curr Sports Med Rep 2021; 20: 109-112
25 Jung EM, Dinkel J, Verloh N. et al. Wireless point-of-care ultrasound: First experiences with a new generation handheld device. Clin Hemorheol Microcirc 2021;
26 Barreiros AP, Cui XW, Ignee A. et al. EchoScopy in scanning abdominal diseases: initial clinical experience. Z Gastroenterol 2014; 52: 269-275
27 Barreiros AP, Dong Y, Ignee A. et al. EchoScopy in scanning abdominal diseases; a prospective single center study. Med Ultrason 2019; 21: 8-15
28 Frohlich E, Beller K, Muller R. et al. Point of Care Ultrasound in Geriatric Patients: Prospective Evaluation of a Portable Handheld Ultrasound Device. Ultraschall Med 2020; 41: 308-316
29 Stock KF, Klein B, Steubl D. et al. Comparison of a pocket-size ultrasound device with a premium ultrasound machine: diagnostic value and time required in bedside ultrasound examination. Abdom Imaging 2015; 40: 2861-2866
30 Wastl D, Lowe A, Dietrich CF. Echoscopy in scanning cardiac diseases in critical care medicine. Med Klin Intensivmed Notfmed 2022 (epub date 2022/06/13) .
31 Wastl D, Lowe A, Dietrich CF. Echoscopy in scanning abdominal diseases in a critical care setting. Med Klin Intensivmed Notfmed 2022 (epub date 2022/06/03).
32 Lo H, Frauendorf V, Wischke S. et al. Ambulatory Use of Handheld Point-of-Care Ultrasound (HH-POCUS) in Rural Brandenburg – A Pilot Study. Ultraschall Med 2021;
33 Vidakovic R, Feringa HH, Kuiper RJ. et al. Comparison with computed tomography of two ultrasound devices for diagnosis of abdominal aortic aneurysm. Am J Cardiol 2007; 100: 1786-1791
34 Judmaier G, Seitz K. How reliable is sonography of the upper abdomen with portable sonographic units? What does the future hold?. Ultraschall Med 2004; 25: 408-410
35 Seitz K, Vasilakis D, Ziegler M. Efficiency of a portable B-scan ultrasound device in comparison to a high-end machine in abdominal ultrasound. Results of a pilot study. Ultraschall Med 2003; 24: 96-100
36 Ziegler CM, Seitz K, Leicht-Biener U. et al. Detection of therapeutically relevant diagnoses made by sonography of the upper abdomen: portable versus high-end sonographic units -- a prospective study. Ultraschall Med 2004; 25: 428-432
37 Ärztekammer Mecklenburg-Vorpommern. Berufsordnung für die Ärztinnen und Ärzte in Mecklenburg-Vorpommern. 2016 https://www.aek-mv.de/upload/file/aerzte/Recht/Rechtsquellen/Berufsordnung_5_6_Aenderung.pdf
38 de (2021). Vereinbarung von Qualitätssicherungsmaßnahmen nach § 135 Abs. 2 SGB V zur Ultraschalldiagnostik (Ultraschall-Vereinbarung). 2021 https://www.kbv.de/media/sp/Ultraschallvereinbarung.pdf
39 Frohlich E, Hofmann J, Debove I. et al. Pictocam instead of Pictogram – a quality improvement study in abdominal ultrasound imaging. Z Med Phys 2016; 26: 251-258
40 Wilkinson JN, Saxhaug LM. Handheld ultrasound in training – The future is getting smaller!. J Intensive Care Soc 2021; 22: 220-229
41 Malik AN, Rowland J, Haber BD. et al. The Use of Handheld Ultrasound Devices in Emergency Medicine. Curr Emerg Hosp Med Rep 2021; 09: 73-81
42 Pedersen JK, Sira C, Trovik J. Handheld transabdominal ultrasound, after limited training, may confirm first trimester viable intrauterine pregnancy: a prospective cohort study. Scand J Prim Health Care 2021; 39: 123-130
43 Zieleskiewicz L, Lopez A, Hraiech S. et al. Bedside POCUS during ward emergencies is associated with improved diagnosis and outcome: an observational, prospective, controlled study. Crit Care 2021; 25: 34
44 Wong RH, Yang F, Fujikawa T. et al. Pocket-Size Mobile Echocardiographic Screening of Thoracic Aortic Aneurysms in Hypertensive Patients. Ann Thorac Surg 2021; 111: 1554-1559
45 McMahon SR, De Francis G, Schwartz S. et al. Tablet-Based Limited Echocardiography to Reduce Sonographer Scan and Decontamination Time during the COVID-19 Pandemic. J Am Soc Echocardiogr 2020; 33: 895-899
46 Acuña J, Sorenson J, Gades A. et al. Handheld Ultrasound: Overcoming the Challenge of Difficult Peripheral Intravenous Access in the Emergency Department. J Ultrasound Med 2020; 39: 1985-1991
47 Sforza A, Mancusi C, Carlino MV. et al. Diagnostic performance of multi-organ ultrasound with pocket-sized device in the management of acute dyspnea. Cardiovasc Ultrasound 2017; 15: 16
48 Yamazaki A, Liu P, Cheng WC. et al. Image quality characteristics of handheld display devices for medical imaging. PLoS One 2013; 8: e79243
49 Rettenmaier G. Sonographic status of upper abdomen. Diagnostic significance and indications of the ultrasonic sectional examination of the upper abdomen. Internist (Berl) 1976; 17: 549-564
50 Philips. Healthcare-in-europe.. Mobile Ultraschalldiagnostik für die Bundeswehr. In. Mobile Ultraschalldiagnostik für die Bundeswehr. 2017 healthcare-in-europe.com
51 Mancusi C, Carlino MV, Sforza A. Point-of-care ultrasound with pocket-size devices in emergency department. Echocardiography 2019; 36: 1755-1764
52 Lisi M, Cameli M, Mondillo S. et al. Incremental value of pocket-sized imaging device for bedside diagnosis of unilateral pleural effusions and ultrasound-guided thoracentesis. Interact Cardiovasc Thorac Surg 2012; 15: 596-601
53 Walcher F, Weinlich M, Conrad G. et al. Prehospital ultrasound imaging improves management of abdominal trauma. Br J Surg 2006; 93: 238-242
54 Wastl D, Helwig K, Dietrich CF. Examination concepts and procedures in emergency ultrasonography. Med Klin Intensivmed Notfmed 2015; 110: 231-239
55 Wastl D, Borgmann T, Helwig K. et al. Rapid diagnostic in the emergency unit: bedside sonography. Dtsch Med Wochenschr 2016; 141: 317-321
56 Hoffmann B, Schafer JM, Dietrich CF. Emergency Ocular Ultrasound – Common Traumatic and Non-Traumatic Emergencies Diagnosed with Bedside Ultrasound. Ultraschall Med 2020; 41: 618-645
57 Dietrich CF, Goudie A, Chiorean L. et al. Point of Care Ultrasound: A WFUMB Position Paper. Ultrasound Med Biol 2017; 43: 49-58
58 Osterwalder J. Das SGUM-Zertifikat Notfallsonographie. Schweizerische Ärztezeitung 2012; 93: 1210-1211
59 Lapostolle F, Petrovic T, Lenoir G. et al. Usefulness of hand-held ultrasound devices in out-of-hospital diagnosis performed by emergency physicians. Am J Emerg Med 2006; 24: 237-242
60 Hilbert-Carius P, Struck MF, Rudolph M. et al. Point-of-care ultrasound (POCUS) practices in the helicopter emergency medical services in Europe: results of an online survey. Scand J Trauma Resusc Emerg Med 2021; 29: 124
61 Nürnberg D, Jenssen C, Cui X. et al. Ultrasound in palliative care medicine. Z Gastroenterol 2015; 53: 409-416
62 Lee C, Balk D, Schafer J. et al. Accuracy of Focused Assessment with Sonography for Trauma (FAST) in Disaster Settings: A Meta-Analysis and Systematic Review. Disaster Med Public Health Prep 2019; 13: 1059-1064
63 Filopei J, Siedenburg H, Rattner P. et al. Impact of pocket ultrasound use by internal medicine housestaff in the diagnosis of dyspnea. J Hosp Med 2014; 9: 594-597
64 Riessen R, Möckel M. Klug entscheiden … in der Notaufnahme (2). Dtsch Ärztebl 2019; 116: A891-A896
65 Michels G, Wengenmayer T, Hagl C. et al. Recommendations for extracorporeal cardiopulmonary resuscitation (eCPR) : Consensus statement of DGIIN, DGK, DGTHG, DGfK, DGNI, DGAI, DIVI and GRC. Anaesthesist 2018; 67: 607-616
66 Michels G, Wengenmayer T, Hagl C. et al. Recommendations for extracorporeal cardiopulmonary resuscitation (eCPR): consensus statement of DGIIN, DGK, DGTHG, DGfK, DGNI, DGAI, DIVI and GRC. Clin Res Cardiol 2019; 108: 455-464
67 Michels G, Zinke H, Mockel M. et al. Recommendations for education in ultrasound in medical intensive care and emergency medicine: position paper of DGIIN, DEGUM and DGK. Med Klin Intensivmed Notfmed 2017; 112: 314-319
68 Nuernberg D, Jenssen C, Frohlich E. et al. Ultrasound in palliative care medicine, Part II. Z Gastroenterol 2017; 55: 582-591
69 Brooks AJ, Price V, Simms M. et al. Handheld ultrasound diagnosis of extremity fractures. J R Army Med Corps 2004; 150: 78-80
70 Akimoto T, Kobayashi T, Maita H. et al. Initial assessment of femoral proximal fracture and acute hip arthritis using pocket-sized ultrasound: a prospective observational study in a primary care setting in Japan. BMC Musculoskelet Disord 2020; 21: 291
71 Maio G. Medicine and the holistic understanding of the human being: ultrasound examination as dialog. Ultraschall Med 2014; 35: 98-107
72 Canepa CA, Harris NS. Ultrasound in Austere Environments. High Alt Med Biol 2019; 20: 103-111
73 Chiao L, Sharipov S, Sargsyan AE. et al. Ocular examination for trauma; clinical ultrasound aboard the International Space Station. J Trauma 2005; 58: 885-889
74 Sargsyan AE, Hamilton DR, Jones JA. et al. FAST at MACH 20: clinical ultrasound aboard the International Space Station. J Trauma 2005; 58: 35-39
75 Reddick V. Ultrasound aboard the international space station. Radiol Manage 2001; 23: 22-24
76 O’Connell K, Bouffard AJ, Vollman A. et al. Extreme musculo-skeletal ultrasound: training of non-physicians in the Arctic Circle. Crit Ultrasound J 2011; 3: 19-24
77 Yetto JM, Yetto TO. Point-of-care ultrasonography for undersea medical officers. 2014 https://apps.dtic.mil/sti/pdfs/AD1003215.pdf
78 Robba C, Santori G, Czosnyka M. et al. Optic nerve sheath diameter measured sonographically as non-invasive estimator of intracranial pressure: a systematic review and meta-analysis. Intensive Care Med 2018; 44: 1284-1294
79 Wipplinger F, Holthof N, Lienert J. et al. Point-of-Care Ultrasound Diagnosis of Acute High Altitude Illness: A Case Report. Wilderness Environ Med 2021; 32: 204-209
80 Dietrich CF. Ultrasound in Student Education. Praxis (Bern 1994) 2018; 107: 1267-1271
81 Dietrich CF, Hoffmann B, Abramowicz J. et al. Medical Student Ultrasound Education: A WFUMB Position Paper, Part I. Ultrasound Med Biol 2019; 45: 271-281
82 Dietrich CF, Hoffmann B, Cantisani V. et al. Medical Student Ultrasound Education, a WFUMB Position Paper, Part I, response to the letter to the Editor. Ultrasound Med Biol 2019; 45: 1857-1859
83 Ho AM, Critchley LA, Leung JY. et al. Introducing Final-Year Medical Students to Pocket-Sized Ultrasound Imaging: Teaching Transthoracic Echocardiography on a 2-Week Anesthesia Rotation. Teach Learn Med 2015; 27: 307-313
84 Hoffmann B, Blaivas M, Abramowicz J. et al. Medical Student Ultrasound Education, a WFUMB Position Paper, Part II. A consensus statement of ultrasound societies. Med Ultrason 2020; 22: 220-229
85 Prosch H, Radzina M, Dietrich CF. et al. Ultrasound Curricula of Student Education in Europe: Summary of the Experience. Ultrasound Int Open 2020; 6: E25-E33
86 Ireson M, Warring S, Medina-Inojosa JR. et al. First Year Medical Students, Personal Handheld Ultrasound Devices, and Introduction of Insonation in Medical Education. Ann Glob Health 2019; 85: 123
87 Galusko V, Khanji MY, Bodger O. et al. Hand-held Ultrasound Scanners in Medical Education: A Systematic Review. J Cardiovasc Ultrasound 2017; 25: 75-83
88 Wong CK, Hai J, Chan KYE. et al. Point-of-care ultrasound augments physical examination learning by undergraduate medical students. Postgrad Med J 2021; 97: 10-15
89 Statement from the DEGUM board regarding the editorial entitled “Who’s Doing Your Scan? A European Perspective on Ultrasound Services.”. Ultraschall Med 2018; 39: 11-13
90 Chiem AT, Lim GW, Tabibnia AP. et al. Feasibility of patient-performed lung ultrasound self-exams (Patient-PLUS) as a potential approach to telemedicine in heart failure. ESC Heart Fail 2021; 8: 3997-4006
91 Kim EY, Park KH, Choi SJ. et al. Educational value of pocket-sized ultrasound devices to improve understanding of ultrasound examination principles and sonographic anatomy for medical student. PLoS One 2017; 12: e0185031
92 Swamy M, Searle RF. Anatomy teaching with portable ultrasound to medical students. BMC Med Educ 2012; 12: 99
93 Patel SG, Benninger B, Mirjalili SA. Integrating ultrasound into modern medical curricula. Clin Anat 2017; 30: 452-460
94 Nelson BP, Narula S, Argulian E. et al. Including Insonation in Undergraduate Medical School Curriculum. Ann Glob Health 2019; 85: 135