Back Room Forum

How Times Have Changed

December 18, 2018 Ultrasound Has Changed

When I began my ultrasound career in the late 70s, ultrasound machines were the size of a refrigerator. Very much like the one I trained on pictured below. Not too long ago, this ultrasound machine was displayed in the vintage/history section at the AIUM. As I walked through the display, I realized that the machines there were not the only things  “vintage” and how times have really changed. 


My very first introduction to ultrasound was as a radiology instructor in the United States Air Force. I was very familiar with x-ray images, fluoroscopy and image processing etc., I did not even know at the time that there was such a thing as examining the human body with sound waves.  

My very first exposure to ultrasound was when I happened upon a small back room in the radiology department.  That room contained a green Picker compound scanner, an old static B-mode scanner (1970’s and new at the time), with a transducer dangling from a mechanically manipulated arm as seen in the photo.  


I was certainly intrigued with its complexity and the strange looking device and images that it produced. Being inquisitive, I learned that the primary purpose of the system was to look for abnormalities concerning pregnancy, gallstones, kidney, liver and fluid in the abdomen. Keep in mind that computerized tomography, or “CT Scan” was not available just yet. The studies in this ultrasound room were mostly centered on imaging of the fetal head, abdomen and amniotic fluid volume of a pregnancy. Also, fetal age, stomach and bladder were important structures to evaluate at the time. It was rare to be able to determine fetal gender until mid or late second trimester. We paid particular attention to the fetus and while some fetal abnormalities were obvious, many by today’s standards were not.

There was also a brand-new real-time machine in that room that everyone was talking about. With this ultrasound machine, one could see the heart of the fetus in live motion. The observer could realize movement of the arms and legs and occasionally witness the fetus sucking its thumb. 

I was so impressed with what I saw that day, I proceed to the Chief’s office to re-enlist for another four years. However, I would do that only if he put me in that back room. To my surprise, he did just that and, I did re-enlist. This was the beginning of my career as an ultra-sonographer. 

Within two years of seeing that ultrasound machine, I took my first of what would be four ultrasound registries with the ARDMS. At that time there were very few formal ultrasound education programs available for sonography. We trained by reading books and learning together with other sonographers, radiologist and cardiologist. My first abdominal and OBGyn registry was sitting with a radiologist interpreting ultrasound images. Those of us testing that day all sat in a waiting room sweating, nervous, and waiting for our name to be called. I was more nervous that day than I was the first time I landed a single engine Cessna by myself.

When I was starting my career, I never imaged that one day an ultrasound machine would fit in the hand and produce images equal to what we see on more advanced ultrasound machines today. 

When these early hand-carried ultrasound imagers were first introduced into areas like emergency medicine and critical care, it was thought that this type of thing should only be in the hands of the cardiology department and the radiology department. “How Times Have Changed”.                                                                                

Today, ultrasound has become somewhat ubiquitous among many medical specialties outside of those that first made an exclusive claim to the privilege of using it.

Currently, one can find ultrasound in nearly every emergency department, critical care setting, orthopedic department/clinic and OBGyn practice. Ultrasound is used extensively in anesthesia for nerve imaging prior to surgical blocks and vascular access.  The technology is now available for nurses performing difficult intravenous access. There is an ever-increasing number of subspecialist and many first responders that work land, sea and air that have or are looking to implement POrtable Hand Carried UltraSound. Or POCUS!

As I see it, there remain at least three obstacles that prevent proliferation of POCUS even further into other medical specialties:   Those would be costtraining and time.

What if there was product that was lower in cost, a product that helped to train the user, and at the same time, interpreted images and some of the information for you? What if there was a product that combined already in use, everyday medical tools and ultrasound in to one? What if that product was affordable, and the company that produced it, provided on-going support and training at the user’s convenience? Welcome to EchoNous!

We will be contributing regular postings to the EchoNous website. These brief articles/videos will be informational and centered around the training aspect for the use of POCUS. We will offer a perspective from a physician user, a sonographer and others. The purpose of the posts will be to share information and provide tips and tricks to obtaining quality results with POCUS. Check back every few weeks for something new. 

By Don Rainville RT(R)., ARDMS (Abd, OBGyn)., RVT., RDCS.

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