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• Cost per use of USS
  Chris M Turner
  Published on: 22 January 2007
• Critical cases direct our needs and skills
  Mahamoud M Gabal
  Published on: 12 December 2006

• Published on: 22 January 2007

  Cost per use of USS

  • Chris M Turner, SpR

  Dear Editor

  In the reponse from Chikungwa and Lim to Dunning's BET they raise concerns with the cost per use of the USS. The cost per use is stated at £10 per time. I would suggest that this could be considerably reduced were the USS be used in a variety of other situations that it is inherently suitable for ,such as the placement of arterial lines, peripheral access in the patient for whom access is a challenge b...

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  Dear Editor

  In the reponse from Chikungwa and Lim to Dunning's BET they raise concerns with the cost per use of the USS. The cost per use is stated at £10 per time. I would suggest that this could be considerably reduced were the USS be used in a variety of other situations that it is inherently suitable for ,such as the placement of arterial lines, peripheral access in the patient for whom access is a challenge but central access is not felt necessary and for the noting of vascular landmarks prior to the placement of nerve blocks. To potentially discard the uss as a useful tool on the basis of Miller's study (in which the perticipants had only been given a one hour teching session and so therefore could not realistically be said to be functioning at an experienced level) would seem a little premature. Besides which, Miller's study shows a statistically significant reduction in the time taken to achieve access, even in these beginners.

  I am also unsure as to why they feel it is not satisfactory to share a device with another department. If the department was situated in close proximity and a suitable storage facility identified (preferrably between the two departments)then I see no difficulty in sharing a piece of equipment.

  Finally,inresponse to the statement about "have a go" I could not agree more. However there are a number of models available to allow the skills necessary to be achieved. In terms of cost effectiveness I refer them to the letter by Gabal Re: Critical cases direct our needs and skills

  Chris Turner

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  Conflict of Interest:
  None declared.

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• Published on: 12 December 2006

  Critical cases direct our needs and skills

  • Mahamoud M Gabal, radiologist

  Dear Editor

  The interest in use of ultrasonography had been increased in the last decade in the interventional procedures both in emergency and in ICU patients .. the question of {to use or not to use }is frequently asked in straight forward cases . and the fair of the suspected complication and cost benefit studies are the most frequent in this field . but the real need is in that cases in which the ultrasonog...

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  Dear Editor

  The interest in use of ultrasonography had been increased in the last decade in the interventional procedures both in emergency and in ICU patients .. the question of {to use or not to use }is frequently asked in straight forward cases . and the fair of the suspected complication and cost benefit studies are the most frequent in this field . but the real need is in that cases in which the ultrasonography must be used . in cases with surgical emphysema ,burn at the usual sites for central venous catheters ,the presence of hematomas in near by structures or massive subcutaneous edema will show no or very diffecult anatomical land marks. the need of ultrasonography guided insertion is obligatory as a life saving technique in these cases .what ever the cost and what ever the non fatal complication this technique must be used in routine practice to gain experience to face such these critical cases . the continuous training with experimental ultrasound models rise the possibility of avoidance of the complication and decrease the time and accordingly the cost and safety of the ultrasound apparatus . ultrasound models solve the problem of the training . simply a cooked potatoes with a tube filed with jell imbedded in it can do a very simple cheap model .the external irregularities at the surface of the potatoes will give an challenge with every use . covering the central part of the probe with a very thin layer of plaster strip will do a central artifact . this artifact when directed over the target can be used as a guide for the needle . the frequent use of the ultrasound models rise the sensitivity of the operator and decrease the risk of the technique .the straight forward cases are considered the next step in the way of gaining skills .the use of a technique as a life saving condition needs many excremental and practical training ......thanks

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  Conflict of Interest:
  None declared.

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