• Jacob Chen, Alex Dobron, Akiva Esterson, Lior Fuchs, Elon Glassberg, David Hoppenstein, Regina Kalandarev-Wilson, Itamar Netzer, Mor Nissan, Rachelly Shifer Ovsiovich, Raphael Strugo, Oren Wacht, Chad G Ball, Naisan Garraway, Lawrence Gillman, Andrew W Kirkpatrick, Volker Kock, Paul McBeth, Jessica McKee, Juan Wachs, and Scott K d'Amours.
• Hospital Management, Meir Medical Center, Kfar Saba, Israel.
• Isr Med Assoc J. 2022 Sep 1; 24 (9): 596-601.

BackgroundHandheld ultrasound devices present an opportunity for prehospital sonographic assessment of trauma, even in the hands of novice operators commonly found in military, maritime, or other austere environments. However, the reliability of such point-of-care ultrasound (POCUS) examinations by novices is rightly questioned. A common strategy being examined to mitigate this reliability gap is remote mentoring by an expert.ObjectivesTo assess the feasibility of utilizing POCUS in the hands of novice military or civilian emergency medicine service (EMS) providers, with and without the use of telementoring. To assess the mitigating or exacerbating effect telementoring may have on operator stress.MethodsThirty-seven inexperienced physicians and EMTs serving as first responders in military or civilian EMS were randomized to receive or not receive telementoring during three POCUS trials: live model, Simbionix trainer, and jugular phantom. Salivary cortisol was obtained before and after the trial. Heart rate variability monitoring was performed throughout the trial.ResultsThere were no significant differences in clinical performance between the two groups. Iatrogenic complications of jugular venous catheterization were reduced by 26% in the telementored group (P < 0.001). Salivary cortisol levels dropped by 39% (P < 0.001) in the telementored group. Heart rate variability data also suggested mitigation of stress.ConclusionsTelementoring of POCUS tasks was not found to improve performance by novices, but findings suggest that it may mitigate caregiver stress.

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