Point of care ultrasound (POCUS)

GE Venu Go POCUS machine knobology

Important

English - Please take a moment to review our disclaimer, as it is critical when consulting the content provided on NeoCardioLab platforms. I would also like to emphasize that neonatal hemodynamics and targeted neonatal echocardiography (TnECHO) are governed by key guidelines that were published and reaffirmed in 2024. I highly encourage all users to familiarize themselves with these guidelines. Safe and effective practice in this field requires not only proper training and expertise but also a system that includes collaboration and standardized practices in imaging, protocolized evaluations, measurements, and reporting. It is important to note that proficiency in this area cannot be achieved through a 2-day course or through casual use of the content on this platform alone. Our goal at NeoCardioLab is to promote knowledge dissemination in neonatal cardiovascular care and provide insights into neonatal hemodynamics. However, consulting this platform’s content does not make one proficient or qualified to practice independently without the appropriate training and institutional safeguards in place. The content is also intended to complement the ongoing education of trainees who are still evolving in the world of hemodynamics, TnECHO, and related cardiovascular sciences. By sharing what we’ve developed at NeoCardioLab, we aim to engage the broader community, spark curiosity, deepen cardiovascular knowledge, and provide additional context to augment monitoring and understanding of cardiovascular physiology. The content should never dictate care in specific clinical scenarios you encounter. These decisions should always be made safely, with the support of your team, expertise, and collaborative multidisciplinary care. Although I have taught 2-day courses on ultrasound, these are designed to provide an introduction to ultrasound-guided care, familiarize participants with key views, and teach basic acquisition techniques. By no means should anyone believe that after such a course they are prepared to practice autonomously. Rather, this should be the starting point for further learning within a structured environment, with safeguards in place, and ongoing mentorship from local experts. I strongly encourage those who attend such workshops to return to their institutions and work within a collaborative system that prioritizes safety and progressive integration of these practices. Be cautious of expensive 1-2 day workshops that claim to make you proficient and licensed to practice TnECHO or cardiac POCUS. Proficiency in these fields requires extensive prolonged training, mentorship, support, collaborative care (with cardiology and/or radiology) and continuous learning. While workshops provide a valuable introduction, the journey toward competency in these techniques is long and requires a solid foundation of knowledge and experience. At its core, TnECHO and POCUS should aim to bring precision to neonatal care—not necessarily to "do more" but often to "do less," with greater accuracy. I hope these words of wisdom help guide how you incorporate the content of this platform into your practice. Enjoy the reading and use of the content on this platform :)!

Français – Veuillez prendre un moment pour lire notre avis de non-responsabilité, car il est essentiel lors de la consultation du contenu fourni sur les plateformes de NeoCardioLab. Je tiens également à souligner que l'hémodynamie néonatale et l'échocardiographie ciblée néonatale (TnECHO) sont régies par des lignes directrices clés publiées et réaffirmées en 2024. J'encourage vivement tous les utilisateurs à se familiariser avec ces directives. La pratique sûre et efficace dans ce domaine nécessite non seulement une formation et une expertise adéquates, mais également un système qui comprend la collaboration et des pratiques standardisées en matière d’imagerie, d’évaluations protocolisées, de mesures et de rapports. Il est important de noter que la maîtrise dans ce domaine ne peut être atteinte en suivant un cours de deux jours ou en utilisant de manière occasionnelle le contenu de cette plateforme. Notre objectif au NeoCardioLab est de promouvoir la diffusion des connaissances en soins cardiovasculaires néonatals et de fournir des perspectives sur l'hémodynamie néonatale. Cependant, consulter le contenu de cette plateforme ne rend pas une personne compétente ou qualifiée pour pratiquer de manière autonome sans une formation appropriée et des garde-fous institutionnels en place. Le contenu vise également à complémenter la formation continue des stagiaires qui évoluent encore dans le monde de l’hémodynamie, de la TnECHO et des sciences cardiovasculaires connexes. En partageant ce que nous avons développé au NeoCardioLab, nous souhaitons engager la communauté, susciter la curiosité, approfondir les connaissances cardiovasculaires et fournir un contexte supplémentaire pour améliorer la surveillance et la compréhension de la physiologie cardiovasculaire. Le contenu ne doit jamais dicter les soins dans les scénarios cliniques spécifiques que vous rencontrez. Ces décisions doivent toujours être prises en toute sécurité, avec le soutien de votre équipe, de votre expertise et d’une prise en charge multidisciplinaire collaborative. Bien que j'aie enseigné des cours de deux jours sur l'ultrason, ils sont conçus pour fournir une introduction aux soins guidés par l’échographie, familiariser les participants avec les vues clés et enseigner les techniques d’acquisition de base. En aucun cas, quelqu'un ne devrait croire qu’après un tel cours, il est prêt à pratiquer de manière autonome. Au contraire, cela doit constituer le point de départ d’un apprentissage supplémentaire dans un environnement structuré, avec des garde-fous en place et un mentorat continu de la part d'experts locaux. J'encourage fortement ceux qui assistent à ces ateliers à retourner dans leurs institutions et à travailler au sein d'un système collaboratif qui privilégie la sécurité et l'intégration progressive de ces pratiques. Soyez prudent face aux ateliers coûteux d'une ou deux journées qui prétendent vous rendre compétent et habilité à pratiquer la TnECHO ou le POCUS cardiaque. La maîtrise de ces domaines nécessite une formation prolongée, un mentorat, un soutien, une collaboration (avec la cardiologie et/ou la radiologie) et un apprentissage continu. Bien que les ateliers offrent une introduction précieuse, le chemin vers la compétence dans ces techniques est long et nécessite une base solide de connaissances et d'expérience. En fin de compte, la TnECHO et le POCUS visent à apporter de la précision aux soins néonatals—pas nécessairement pour "faire plus", mais souvent pour "faire moins", avec une plus grande précision. J'espère que ces mots de sagesse vous guideront dans l'intégration du contenu de cette plateforme à votre pratique. Bonne utilisation et lecture :). 

Quick Guide: GE Venue Go POCUS Machine in the NICU

This guide provides a basic overview of how to use the GE Venue Go machine for point-of-care ultrasound (POCUS) in the neonatal unit, drawing on the provided YouTube transcript.

1. Machine Basics & Probes

• The GE Venue Go is a card on four wheels that is easy to move around the unit. You can lock/unblock the wheels for motion.

• The probes are typically stored on top of the machine and should be handled with gentle care.

• This system has five probes. The source describes four:

  • 12S Probe (Sector Array): Around 10-14 MHz. Higher frequency for more superficial structures with better resolution. Good for cardiac applications (heart evaluations) because it handles motion well.

  • 6S Probe (Sector Array): 6 MHz. Lower frequency, allows ultrasound waves to go deeper into tissue. Good for bigger babies (>3kg, like infants of diabetic mothers) to get better cardiac views.

  • 8C Probe (Curvy Linear): Around 8 MHz. Curvy linear shape. Good for abdominal applications (bladder, free fluid, liver, kidneys, spleen). Also a good probe for neonatal head scans via the fontanelle access (massive bleeds, intraventricular hemorrhages, hydrocephalus/ventriculomegaly).

  • L10-22 Probe (Linear): L for linear, 10-22 MHz. Very high frequency for very superficial imaging. Good for vascular access (e.g., obtaining views for needle insertion in veins/arteries, assessing umbilical line tips). Has a marker on the probe that corresponds to a marker on the screen.

  • Hockey Stick Probe (Linear): A type of linear probe. The marker represents the actual tip of the probe, corresponding to a marker on the screen. Useful for vascular access for needle procedures.

2. Connecting & Selecting Probes

• The machine has three ports on the back for connecting probes.

• To connect, gently press the probe into the port and then lock it in. The connected probe will appear on the screen for selection.

• The screen is all touchscreen.

• The top of the screen shows the currently used probe and preset (in order of connection).

• To select a connected probe, go into the area on the screen that shows the probes. Choose the probe graphically, and then select the desired application preset (e.g., Neo Head, Abdomen, Artery). Selecting a preset organises the machine settings appropriately.

3. Starting an Exam

• The power button is on the machine. You can click it to turn the machine on or take it off standby.

• Before scanning a patient, use appropriate wipes to clean the machine and probes.

• To start an exam, select "Patient".

• You can enter a test MRN (e.g., 000000) or use "Auto ID" which assigns the date and time and keeps everything else anonymous.

• You can enter the patient's last and first name.

• Click "Begin Exam" when ready to scan. You can resume an exam later by going back to the "Patient" button.

4. Basic Scanning & Image Acquisition

• Use gel on the patient's skin.

• B-mode (B modes = by dimensional mode) is the 2D mode of imaging.

• To see blood flow, you can use Color Box. Move and reshape the colour box over the area of interest. The scale shows the velocity. Red colour typically means blood flow is coming towards the probe, blue means it is going away.

• You can get a simultaneous view showing both 2D (B-mode) and Colour imaging.

• Depth can be adjusted to focus on structures at different depths. You can use the depth control on the side or slide a control on the screen. Sliding down increases depth (deeper), sliding up makes it shallower.

• Gain adjusts the enhancement of the ultrasound signal. Increasing gain makes the image brighter. This can be adjusted on the touchscreen.

• Width adjusts how much area you are focusing on. Narrowing the width can improve image quality for a specific structure, but a wider view might be needed for quick overall evaluations.

• You can flip the image (e.g., up-down) using a button on the side, especially sometimes for cardiac views.

• The Reverse (R) button on the side can be used to reverse the sidedness of the image on the screen, changing which side corresponds to the probe marker.

• The probe has a marker that corresponds to a marker on the screen. This helps orient you regarding the sidedness of the imaging. For the curvy linear probe, the marker side on the probe appears where you see the GE Venue marker on the screen. What is deeper appears at the end of the frequency window. A triangle on the curvy linear probe shows the exact middle.

5. Freezing & Storing Images/Loops

• To pause the live image, click "Freeze".

• When frozen, you can use a cursor to go back frame by frame or play the loop that was just captured. The loop duration is shown.

• You can select a specific section of a loop to store.

• To store an image or a selected loop segment, click "Store". You can store a frozen still frame directly by freezing and storing without playing the loop.

• When playing a loop, you can slow down or speed up the playback.

6. Measurements

• When an image is frozen, you can perform measurements.

• Click the "Measurements" button (or caliper icon).

• Use calipers by clicking on the screen to define points for distance measurements. The measurement appears on the screen.

• Specific tags or measurement types may be available depending on the preset (e.g., "Neonatal Head" has "Area" and "Caliper").

• An Area measurement allows you to trace an area.

• A Volume measurement can be estimated using distances from different image planes, though this is rarely used in POCUS.

• For vascular access, there's a "Catheter Ratio" measurement under "Vascular Access". You can select a gauge and measure the vessel diameter, and it will estimate the percentage of the lumen the catheter would fill.

• Under "Generic", you can use calipers for general measurements like skin-to-vessel distance.

• Measurements can also be done on images that have already been acquired and are being reviewed.

7. Reviewing Images

• Click "Review" to look at stored images.

• You can scroll through stored images on the screen.

• Double-click on an image to view it fullscreen. Other stored images will appear smaller on the side.

• You can perform further measurements on reviewed images or delete images you don't want to keep.

8. Ending the Exam & Saving

• When finished, click "End Exam".

• Confirm that you want to save your exam by clicking "Yes".

• Exams are saved under "Local Archive". You may be prompted for a password (the source states their machine has no password).

• In the local archive, you can find your studies (e.g., by the patient ID/name) and open them.

9. Cleaning

• After use, clean all probes.

• To clean the machine screen without activating touchscreen functions, press the power button and select "Clean". This blocks the screen. To unlock, slide right.

• You can put the machine on standby or shut it down.

This covers the core operations described in the video for using the GE Venue Go POCUS machine in the NICU. There are many other advanced options and measurements not covered in this basic overview.