The Point-Assisted Spinal Sonography (PASS) is an ultrasound-guided device designed to engage the ultrasound probe that scans for the precise location, degree, and depth of needle penetration into the spinal canal to reduce the chance of the needle hitting the spine and decrease the pain for the patient.
“Practically, the anesthesiologist cannot insert the needle in the best position from the obtained image because the ultrasound probe is blocking the needle’s position, but PASS makes precise needle insertion possible with less chance of the needle hitting the bone or internal vessels,” says Assoc. Prof. Dr. Ketchada.
PASS has two components: a “frame” designed to fit over the ultrasound probe, and a “needle guide slot” to control the direction of the needle to penetrate the spinal canal. The needle guide slot is disposable to prevent infection, but the frame can be disinfected and reused 10 times. university thailand
Assoc. Prof. Dr. Ketchada explained the PASS operation as follows:
Assemble the sterilized frame and needle guide slot.
Put PASS on the ultrasound probe.
Perform an ultrasound scan until the spinal canal is visible.
Pause the imaging to measure the location and position of LP from the display.
Unscrew the ultrasound probe from the PASS frame
Insert the needle through the “needle guide slot”, which will manually guide the needle towards the target (instead of drawing a line on the patient’s skin), it will travel through the skin into the subarachnoid space of the spinal cord until the measured depth is reached.
Slowly remove the PASS frame. Be careful not to let the needle move.
Aspirate the spinal fluid from the puncture point.
PASS and its 4 distinctive designs
PASS is designed to optimize the performance of anesthesiologists when administering epidural, and general practitioners or neurologists who have to diagnose the disease by spinal tap. Assoc. Prof. Dr. Ketchada summarized the four strengths of PASS as follows:
Safety – PASS is made of non-toxic, medical-grade resin for medical devices that are light and safe.
Ergonomic design – designed to be easy to use with the ultrasound probe.
Accessible price – the PASS frame can be reused after sterilization, thus reducing waste and saving costs, but the needle guide slot, which comes in direct contact with the needle is contaminated and must be disposed of.
Distribution – Collaboration with ultrasound equipment companies is possible to design a PASS that fits the various models of ultrasound probes. It is easy to produce. Production capacity can be increased quickly.
However, PASS has some limitations.
“Each brand of ultrasound machine has different probes, so we have to create a model that fits each probe. We also have to calibrate the device to be more precise, since there are still a few errors,” Assoc. Prof. Dr. Ketchada explained.
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