Wilderness Medicine Podcast · Wilderness Medical Society

#30: Portable Ultrasound and a Deep Dive into Diving Med

June 26, 2023·1 hr 15 min·6 clips

Could maple syrup replace ultrasound gel in remote medical emergencies?

This episode of the Wilderness Medicine Podcast features hosts Dr. Darrell and guest host Dr. Fred Bossert interviewing study authors Dr. J.D. Storn and medical student Jennifer Ray. They analyze a study comparing improvised liquids to commercial ultrasound gel for use in wilderness settings. The study tested nine substances, including water, soap, shampoo, olive oil, energy gels, maple syrup, hand sanitizer, sunscreen, and moisturizing lotion. Two ultrasound models were scanned using eight standard anatomical windows, with blinded reviewers assessing image quality. All tested substances except sunscreen were found to be non-inferior to commercial gel for making a clinical decision. In secondary technical assessments, all substances, including sunscreen, performed adequately. The study originated from a humorous discussion about New Hampshire maple syrup, which is listed in state protocols for treating hypoglycemia. A key limitation noted is the user-dependent nature of ultrasound and the controlled conditions of the study. The authors caution against using bug sprays or hydrocarbons like DEET, which could damage ultrasound probes. Energy gels, particularly a double-shot espresso variant, proved exceptionally sticky and difficult to clean. The hosts then transition to a segment on diving and marine medicine, emphasizing the value of specialized training like the Diploma in Diving and Marine Medicine. They reference a case report in Military Medicine about an altitude dive in an ice lake at 3,000 meters. The discussion highlights the importance of practicing both high-tech and fundamental skills, using video versus direct laryngoscopy in emergency medicine as an analogy. A fellowship retreat on Catalina Island included training with LA County Baywatch and a visit to a hyperbaric chamber. A simulated rescue scenario revealed challenges in radio communication between experienced providers and less-trained individuals. Dr. Nick Weiss offers advice on radio etiquette, including performing sound checks, using clear call signs, and speaking slowly and briefly. Common procedural terms like "come in," "go ahead," and "copy" are explained to improve clarity. The episode maintains a conversational and educational tone, blending academic review with practical anecdotes and field stories. It is ideal for emergency medical providers, wilderness medicine enthusiasts, and anyone interested in point-of-care ultrasound or dive medicine. Listeners seeking a highly structured, single-topic lecture might find the conversational segues less engaging.

As heard by us

Ultrasound substitutes, dive medicine, and high-altitude illness in one practical wilderness-medicine discussion.

The episode brings together ultrasound, diving, and high-altitude medicine, then closes with a short primer on radio communications. The ultrasound section is the most immediately useful: it focuses on substitute gels and notes that wipes, energy gel, sunscreen, and other sticky…

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Why you'd press play

You want ultrasound tricks that still matter when the lake is at 9,300 feet.

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