Digital Medical Instruments for Your Phone

The effect of the smartphone on technological advances is undeniable. With apps for everything these days people are expanding to a peripheral market to expand the functionality of smartphone products. If you are in medicine, there are some fun gadgets you might consider adding to your black bag arsenal of portable instruments.

Smartphone Adjuncts

Of course you could use your phone as a reflex hammer, but that is just not as exciting as having a few gadgets and gizmos on hand. So if you are looking for a medical gift or something to put on your wish list you might consider some of these ideas that are sure to draw some attention from your coworkers. Many of these have either received FDA approval or are in the process of doing so and will be available for purchase soon. The majority of these devices are expanding use beyond the Apple operating system so keep an eye out for developments if you do not already use the iPhone.

Stethoscope

• Price - $90
• Designed for iPhone/iPod but it looks like it would function in any headphone jack
• App not needed
• Other - iStethoscope Pro app ($0.99), Does not require attachment

Pulse Oximeter

• Price - Unknown
• Designed for iPhone and works with Android, Windows etc
• App required

 Blood Pressure Monitor

• Price - $130
• Designed for iPhone, iPad and iPod
• App required

Electrocardiogram (ECG)

• Price - Less than $100
• Designed for iPhone and iPod Touch, plans to be available for other operating systems
• App required

Blood Glucose Monitor

• Price - $80
• Designed for iPhone and iPod Touch
• App required (Free)

Dermatoscope

• Price - $1,200
• Designed for iPhone 4
• App required ($5.00) Compatible on iPhone, iPad and iPod Touch. Can be used without the attachment.

Ultrasound

• Price - $7,500
• Not currently available on a smartphone but expected to integrate that function eventually
• Available only to medical professionals and comes with visualization device

The practicality of some of these devices is obvious. When traveling or doing house calls to friends and family they could definitely be useful to have on hand. If you are aware of any similar products, I would love to add them to the list. Please take a minute to comment on them below with any information you have found.

Question of the Week

A mother brings in her 3 year old child for a well-baby office visit. She is concerned her child is not progressing normally because he has not memorized his own name, address and phone number? You explain that children are expected to obtain these skills at which of the following ages?

A. 12 months
B. 3 years
C. 5 years
D. 7 years
E. 9 years

Answer & Explanation

Post Operative Rehabilitation

I am finishing orthopedic surgery this week and thinking back over all the things I have learned. Basically, if it hurts take an anti-inflammatory, when that doesn't work we start poking holes in your joints and if that is no longer helping we fix you surgically. Then you get pain killers, numerous follow up visits and lots of physical therapy.

Bionic Therapy 

I happened to get a sneak peak at patients in therapy and wondered, "who really has time to do rehab anymore?" Every now and then I hear about TENS units as a therapeutic option for pain control and rehabilitation. Once upon a time I came across one and played with it for a few minutes which was rather amusing. Without making any effort at all, the muscle under the pads contract and your body contorts accordingly as if you were signaling the movement. These muscle stimulators take the work out of therapy and let the electricity carry the responsibility. It may not be the best method of recovery, but it is certainly an alternative option. For additional information about LGMedSupply's products visit their online customer blog.


Personally, I feel that physical therapy is designed to be strenuous to muscle to help build tone, resistance, and muscle memory. Getting back into routine activities can be difficult without the proper training and many of the patients we see have mixed feelings about their post-operative therapy. Electrical stimulating devices may be a part of that process, but should not replace the participation in other therapeutic activities. As my use of such devices is limited, I would be interested in hearing your experiences with TENS units and the usefulness of physical therapy.


Question of the Week

A 25 year old active male visits your office after experiencing a twisting injury of his right leg during a soccer match. On exam you palpate and hear clicking when performing a McMurray test. There is a negative Lachman's and posterior drawer test. Varus and valgus stressing shows no laxity of the knee joint. The initial step in management for this patient would be to


A. Immobilization with a leg brace
B. Arthroscopy of the affected joint
C. Prescribe cryotherapy and NSAIDs
D. Obtain an X-ray of the knee
E. Order magnetic resonance imaging of the knee


Answer & Explanation

Suturing Skills

As medical students we are in the business of learning. Some things are well learned on the job, others are better honed on our own and then practiced under close supervision before getting too far ahead of our skill level. 

Tying It All Together

The baby was out, the placenta delivered, and now we had to repair the laceration. When my attending handed me the loaded needle driver, I was a little hesitant as I have not yet sutured living flesh. Without a problem, I was able to approximate the wound from one side of the tear the other. Having only practiced a couple suture ties on pigs feet, I was in unfamiliar territory and I had to let my preceptor know. Sadly he finished the job I started, despite my desire to learn.

This meant I would certainly be learning more on suturing techniques that night so I could be a little more prepared should another opportunity arise. I was happily surprised at the few things I did find and would like to share them here for those who may be a beginner at the art of suturing.

• Suture Basics - Website compiled by Boston University School of Medicine
• Suture Handling Videos - Website produced by University of Pennsylvania
• Knot Tying Kit - FREE Practice kit from Ethicon (Enter your information and they will ship it to you at no cost)
• Surgical Knots and Suturing Techniques - Book written by F.D. Giddings

With another surgery coming up tomorrow, we'll see if I get a chance to wield the needle and string. If it doesn't happen, my dental floss and fruit peels will have to hold me over until my surgical rotations come around. 

Question of the Week

A 24-year-old man is involved in a motorcycle accident and loses several liters of blood. In addition to resuscitation with normal saline, physicians decide to transfuse blood products. If the patient has blood type B, Rh-negative, which of the following blood products may be most safely administered?

A. Type A, Rh-negative red blood cells
B. Type AB, Rh-negative red blood cells
C. Type B, Rh-positive whole blood
D. Type O, Rh-negative red blood cells
E. Type O, Rh-negative whole blood

Answer & Explanation

Easing the Pain

Like something seemingly out of a torture camp the Transcutaneous Electrical Nerve Stimulation (TENS) unit is actually designed to relieve pain and discomfort through a small portable device. 

A New State of Comfort

Finally able to breath again and catch up on my sleep, I still find my back and neck sore from the long hours of hunching while studying for exams. A good night's rest and a session of yoga at the gym quickly helped ease some of the tension that built up over the last couple weeks. For some people, however, pain can be an ongoing problem that limits their daily functioning and even compromises optimal health. Recently, I heard about muscle stimulators and their non-invasive approach to easing sensory and motor deficits. Despite their evil look, some people swear by their effectiveness as adjunct to common medicine.

Although not effective in all cases of chronic pain, TENS Units are an alternative approach to the use of medications and more invasive methods of treatment that aim to reduce neuropathic pain. By stimulating nerves to release inhibitory (GABA) signals, the sensation of pain can be reduced. Among the research is a case that shows there may be some benefit to the use of such systems in restoring sensation where it has previously been diminished. For additional information about LGMedSupply's products visit their online customer blog. Otherwise, if you have used a similar device, I would be interested in hearing your feedback on the subject.

Board Prep Question of the Week

An 18-year-old girl from Southeast Asia presents with symmetric ascending weakness below her knees. She has been unable to walk for 3 days. Physical exam reveals mild hypotension and papilledema. Upon respiratory support and administration of IV immune globulins and plasmapheresis, her condition resolves after 2 weeks. Which of the following is the most likely etiologic agent of her condition?

A. Acid sphingomyelinase deficiency
B. Arylsulfatase A deficiency
C. Infection with C. jejuni
D. Infection with JC virus
E. Microsatellite instability on chromosome 4

Answer & Explanation

Anatomy of a Stethoscope

The signature tool of the trade, stethoscopes have heard it all. Despite being a well crafted instrument, their versatility makes them a "must have" in the field of medicine.

Stethoscopes

Originally a device made of wood, stethoscopes and their evolution have given diagnosticians enhanced hearing capabilities. Ranging from drug store knockoffs to professional Littmann stethoscopes, pediatric to cardiology, short or long, there is certain to be one that will meet your needs. Through the years I have used many, never really understanding their differences...at least until a few weeks ago.

I was recently gifted my first Littmann stethoscope. From experience, I know having eartips in for extended periods of time gets uncomfortable after a while, and draping the tubing around my neck can be awkward if it is stiff. My new stethoscope has extremely soft earpieces and tubing which permit greater comfort than I previously knew. As for auscultating breath, heart, digestive and vascular sounds, my lack of experience at this stage limits my judgment. Nonetheless, I like what I am hearing. Now I just have to find willing subjects for more auscultatory practice.

Board Prep Question of the Week

A 48 year-old female presents with progressive shortness of breath and anxiety. She has no notable prior medical history, and on physical exam, auscultation reveals an opening snap over the cardiac apex followed by a mid-diastolic rumble. The most common cause of her disease process is which of the following?

A. chronic hypertension causing dilatation of the left ventricle
B. repeated attacks of Streptococci causing valvular lesions
C. primary pulmonary hypertension causing atrial dilatation
D. a congenital atrial-septal defect causing chronic hypoxemia
E. a congenital bicuspid valve causing increased afterload of the left ventricle

Answer & Explanation

Wireless Mobile Phones

As technology advances, similar improvements can be seen in the medical field. The possibility of having communication devices at our fingertips has changed our approach to simple tasks. With smartphones now available in all shapes and sizes, technology continues to maintain its "coolness" with the added bonus of simplified communication.

Smartphones

Knowing full well that in less than a year I will be working in the clinics and hospitals among physicians and patients, I wanted to ensure that I had one of the most helpful tools in my pocket. Where a Personal Digital Assistant or book may have useful applications they still lacks in communication. The smartphones, on the other hand, are all encompassing with everything from internet and wireless communication to user friendly applications that make life easier.

Within the last few years the smartphone market has become increasingly saturated with new brands and models to meet diverse personal needs. In my recent hunt for the right phone I was able to narrow my search with the help of Top Ten Reviews. With so many options, it was helpful to have one place with customer reviews and technological differences.

In the end I chose to purchase Apple's iPhone for a number of reasons. A large portion of the purchase cost ($400 to be exact) is covered by AT&T making the initial out-of-pocket cost more affordable. To my surprise, the technology is rather easy to use and navigate, even for a beginner. With an expanding collection of applications, the iPhone has a versatile array of uses for many settings including the medical field, which was a critical deciding factor in my case. Although it may be a little more expensive than some of its counterparts, I felt the iPhone was the best fit for my particular medical student needs and will be an indispensable tool in my professional aspirations.

AT&T Gift Card

I have also recently learned that with a new AT&T account you can receive a $25 dollar gift card when referred by an existing user. That said, if you are planning to switch to AT&T or have recently joined AT&T, leave a comment on this post to that effect and I will provide you with the information needed to get your $25. Just be sure to leave your name and a means to contact you. Consider it your bonus for getting to the end of this post!