Battling fire and ice: remote guidance ultrasound to diagnose injury on the International Space Station and the ice rink

Background National Aeronautical and Space and Administration (NASA) researchers have optimized training methods that allow minimally trained, non-physician operators to obtain diagnostic ultrasound (US) images for medical diagnosis including musculoskeletal injury. We hypothesize that these techniques could be expanded to non-expert operators including National Hockey League (NHL) and Olympic athletic trainers to diagnose musculoskeletal injuries in athletes. Methods NHL and Olympic athletic trainers received a brief course on musculoskeletal US. Remote guidance musculoskeletal examinations were conducted by athletic trainers, consisting of hockey groin hernia, knee, ankle, elbow, or shoulder evaluations. US images were transmitted to remote experts for interpretation. Results Groin, knee, ankle, elbow, or shoulder images were obtained on 32 athletes; all real-time US video stream and still capture images were considered adequate for diagnostic interpretation. Conclusions This experience suggests that US can be expanded for use in locations without a high level of on-site expertise. A non-physician with minimal training can perform complex, diagnostic-quality examinations when directed by a remote-based expert.