Introduction
Point-of-care ultrasound (POCUS) is utilized in austere environments because it is
lightweight, durable, battery powered, and portable. In austere settings, weight and
space constraints are limitations to carrying dedicated ultrasound gel. Few studies
have assessed commonly carried liquids as gel alternatives. The study objective was
to assess the suitability of common food and personal care products as ultrasound
coupling agents compared with that of commercial gel.
Methods
A noninferiority study compared 9 products to commercial gel. Each substance was independently
tested on 2 subjects by 2 sonographers covering 8 standardized ultrasound windows.
Clips were recorded, blinded, and independently graded by 2 ultrasound fellowship-trained
physicians on the ability to make clinical decisions and technical details, including
contrast, resolution, and artifact. A 20% noninferiority margin was set, which correlates
to levels considered to be of reliably sufficient quality by American College of Emergency
Physicians’ guidelines. The substances included water, soap, shampoo, olive oil, energy
gel, maple syrup, hand sanitizer, sunscreen, and lotion.
Results
A total of 300 of 318 (94%) clips met the primary endpoint of adequacy to make a clinical
decision. All media, except sunscreen, were noninferior to commercial gel in the ability
to make a clinical decision (α=0.05). In terms of secondary outcomes, resolution,
artifact, and contrast, all substances were noninferior to commercial gel (α=0.05).
The sonographers concluded that all gel alternatives’ usability performed similarly
to commercial gel, with the exception of energy gel.
Conclusions
Of the 9 substances tested, 8 were noninferior to commercial gels for clinical decisions.
Our study indicates that several POCUS gel substitutes are serviceable to produce
clinically adequate images.
Keywords
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Article info
Publication history
Published online: February 18, 2023
Accepted:
December 7,
2022
Received:
September 13,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2022 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.
