Page 100 - JSOM Fall 2025

devices in maritime settings, due to its specific requirements, Author Contributions
such as the study by Karimpour et al. To determine whether BT designed this research, collected, and analyzed the data and
7
images obtained using handheld ultrasound devices can be drafted the original manuscript. JvdV designed this research,
used for diagnosis of decompression stress, future research collected the data, reviewed, and edited the manuscript. BBB
should also focus on the possible difference in image quality led the experiment, reviewed, and edited the manuscript. CM
between those obtained by handheld ultrasound devices as assisted the experiment, collected data, and reviewed and ed-
compared to standard ultrasound machines. Future studies ited the manuscript. PJvO designed this research reviewed and
7,8
should evaluate how performing ultrasound procedures in edited the manuscript. RH designed this research, led the ex-
outdoor settings with external distracting factors, such as on periment, and reviewed and edited the manuscript. All authors
the waterside, affects the quality of recordings. read and approved the final manuscript.
The prevailing conditions in maritime combat zones, including Disclosures
the Red Sea and the Somali coast, underscore the significance The authors have nothing to disclose.
of military operations and the critical need for ongoing ad-
vancements in technical and medical domains. Additionally, Funding
the 2022 sabotage incident involving the Nord Stream Pipe- This research was supported by the Netherlands Ministry of
line highlights the relevance of underwater warfare. Increasing Defense.
medical equipment availability and applicability for skilled
end users, the operators at sea, facilitates earlier identification References
of hazardous physical conditions, allowing for earlier medical 1. Vann RD, Butler FK, Mitchell SJ, Moon RE. Decompression ill-
screening to prevent medical emergencies. ness. Lancet. 2011;377(9760):153–164. doi:10.1016/S0140-6736
(10)61085-9
2. Pollock N. Use of ultrasound in decompression research. Diving
Limitations Hyperb Med. 2007;37(2):68–72.
One study limitation is the use of a non-validated scale, pos- 3. Le DQ, Dayton PA, Tillmans F, et al. Ultrasound in decompres-
sibly prone to subjectivity, to assess ultrasound recording sion research: fundamentals, considerations, and future technol-
quality. Despite this, we believe our results suggest that the ogies. Undersea Hyperb Med. 2021;48(1):59–72. doi:10.22462/
recordings were generally of good quality. Another limitation 01.03.2021.8
of this study pertains to the homogeneity of the participant 4. Germonpré P, Papadopoulou V, Hemelryck W, et al. The use of por-
population, consisting exclusively of physically fit, military table 2D echocardiography and frame-based’ bubble counting as a
tool to evaluate diving decompression stress. Diving Hyperb Med.
personnel with low body fat. Consequently, the generalizabil- 2014;44(1):5–13.
ity of the findings to civilian demographics is limited. 5. Niitsu H, Hirabayashi N, Yoshimitsu M, et al. Using the Objec-
tive Structured Assessment of Technical Skills (OSATS) global
rating scale to evaluate the skills of surgical trainees in the op-
Conclusion erating room. Surg Today. 2013;43(3):271–275. doi:10.1007/
This microteaching program is an effective training technique s00595-012-0313-7
for military non-medical personnel with little to no ultrasound 6. Møllerløkken A, Blogg SL, Doolette DJ, Nishi RY, Pollock NW.
Consensus guidelines for the use of ultrasound for diving research.
experience to obtain usable ultrasound images of the IVC and Diving Hyperb Med. 2016;46(1):26–32.
PV. This suggests that combat medics could perform vascular 7. Karimpour K, Brenner RJ, Dong GZ, et al. Comparison of newer
ultrasound measurements on the waterside, which could be hand-held ultrasound devices forpost-dive venous gas emboli
used to screen for high decompression stress in the future, if a quantification to standard echocardiography. Front Physiol. 2022;
validated scoring system was to be developed, enhancing op- 13:907651. doi:10.3389/fphys.2022.907651
erational readiness. 8. Slader M, Young H, Barker M, et al. A comparison of handheld and
standard ultrasound in Swiss medical students. World J Emerg Med.
2022;13(2):85–90. doi:10.5847/wjem.j.1920-8642.2022.017
Acknowledgments
The authors would like to acknowledge the Ministry of De- PMID: 40953409; DOI: 10.55460/ETP1-7VPU
fense of the Netherlands for the opportunity to perform this
research.

98 | JSOM Volume 25, Edition 3 / Fall 2025