JMIR Publications

ABSTRACT

Background:

Fluid assessment in geriatric inpatients is challenging as clinical signs are often unreliable. Inferior vena cava (IVC) ultrasound provides rapid, non-invasive estimation of intravascular volume. Tele-guided point-of-care ultrasound (POCUS) allows examiners without prior ultrasound experience to perform scans under real-time supervision.

Objective:

To evaluate feasibility, accuracy, efficiency, and user satisfaction of remote-guided IVC ultrasound performed by medical students and nurses without prior ultrasound experience in a geriatric inpa-tient setting.

Methods:

Thirty hospitalized geriatric patients underwent two IVC ultrasound exams each (n=60) using a handheld device with TeleGuidance™: one performed by a medical student and one by a nurse. All scans were remotely supervised by an ultrasound-experienced cardiologist, who subsequently performed an independent IVC scan on every patient serving as the gold standard. Examiners were two final-year medical students and two nurses, all without ultrasound experience, each performing 15 scans. Outcomes were technical feasibility, accuracy of IVC diameter measurement (≥80% within ±2 mm), duration (≤10 minutes), satisfaction (≥75/100), and profession-specific perfor-mance.

Results:

Connectivity and remote supervision were consistently stable, enabling completion of all scans (feasibility 100%). Accuracy was achieved in 48/60 scans (80%). Mean duration was 3.0±1.6 min (students) and 3.5±2.3 min (nurses). Satisfaction averaged 89% (all scores were ≥85%). Nurses reached 90% accuracy (27/30) vs. 70% for students (21/30; p=0.104).

Conclusions:

Remote-guided bedside ultrasound was feasible, efficient, and well accepted. It may support interprofessional task-sharing in geriatric care. Larger studies are required to validate integration into clinical practice. Clinical Trial: Trial Registration: German Clinical Trials Register (Germany) DRKS00035821