So, you want to take that pretty little laptop ultrasound, put it into your backpack, and fly to parts unknown to help with patient care and/or to teach in a resource-limited setting? Not so fast, I say.
Donating or sharing your skills is a wonderful act and one that I highly recommend. But I don’t want you to end up on a 3-week scanning trip with nowhere to plug in your ultrasound machine and only 35 minutes left on your battery. It’s happened to me and it’s not pleasant. So below are some tips to consider if your next vacation finds you scanning in a remote village.
- The issue with electricity. There is a lot to consider when it comes to electricity. For starters, many countries have “rolling” power outages, which is a euphuism for no electricity when you need it most. How will you handle that situation? Oh, and don’t forget about voltage. Most machines will work on 110 or 220 volts, but I have had surges up to 400 volts. By the way, that is not good for ultrasound machines.
- Charging. How long does it take to charge your equipment? What about if you have to use solar power? And what if it’s rainy or you are scanning at night?
- How many tubes of gel do you need? I use about 1 tube per day per machine when scanning all day. Can you bring enough for your trip? If so, great. If not, do you make your own? Remember that homemade gel, while it does work, is of lower viscosity than commercial gel and gets very runny in the heat. Plus it smells like rotten vegetables after 1-2 days.
- Mind the heat. When you get hot, your machine gets hot. Use a cooling fan for both you and your machine when the ambient temperature is above 90 degrees Fahrenheit. If you need a break from the heat, give your machine a break as well and turn it off.
- What about the cold? Did you know that ultrasound probes are not engineered for cold temperatures? And when it gets below freezing image degradation is a problem. What do you do? Put those transducers and gel tubes into your pants pockets to keep them warm. Sure, you might get some strange looks, but the equipment and your patients will thank you.
- Do you want your teaching to leave a lasting impression? We all know that “the eye does not see what the mind does not know.” If you are looking to train people on your scanning vacation, you have to do what you have time to do. The key is to do what is best for the person you are training regardless of how much time you have. Make sure you have lots of hands-on and one-on-one time before you leave. Develop QA and QI plans in place before you leave or plan on multiple repeat visits to update and follow the progress of the person you are training.
- Avoid the bribe. What do you do if a customs official wants a $20,000 “deposit” before he will let you bring your machine into his country? The easiest first move is to tell him it’s just a laptop. We all know that most of the guts of ultrasound is in the probes. Luckily in many countries the customs officials have not figured that out yet–so don’t tell them. If this doesn’t work and you are not going to get out of the airport without a payoff, bond the machine. Bonding is a legal way of leaving your goods at the airport, and all airports around the world have a bonding process, which costs about $3 per day. Granted, you will have to leave your machine at the airport, but I have learned that there may be more to life than ultrasound!
Have you scanned in another country? What are your tips or suggestions? What have you learned from donating your skills? Comment below or let us know on Twitter: @AIUM_Ultrasound.
“Ted” Kuhn, MD, is professor of emergency medicine and professor of pediatrics at the Medical College of Georgia at Georgia Regents University. He, together with his wife, has lived and worked in Asia and led nearly 100 international medical trips.