title: An easy-to-build, low-budget point-of-care ultrasound simulator: from Linux to a web-based solution.
abstract: BACKGROUND
  Hands-on training in point-of-care ultrasound (POC-US) should ideally comprise bedside teaching, as well as simulated clinical scenarios. High-fidelity phantoms and portable ultrasound simulation systems are commercially available, however, at considerable costs. This limits their suitability for medical schools. A Linux-based software for Emergency Department Ultrasound Simulation (edus2TM) was developed by Kulyk and Olszynski in 2011. Its feasibility for POC-US education has been well-documented, and shows good acceptance. An important limitation to an even more widespread use of edus2, however, may be due to the need for a virtual machine for WINDOWS®systems. Our aim was to adapt the original software toward an HTML-based solution, thus making it affordable and applicable in any simulation setting.
  
  
  METHODS
  We created an HTML browser-based ultrasound simulation application, which reads the input of different sensors, triggering an ultrasound video to be displayed on a respective device. RFID tags, NFC tags, and QR Codes™ have been integrated into training phantoms or were attached to standardized patients. The RFID antenna was hidden in a mock ultrasound probe. The application is independent from the respective device.
  
  
  RESULTS
  Our application was used successfully with different trigger/scanner combinations and mounted readily into simulated training scenarios. The application runs independently from operating systems or electronic devices.
  
  
  CONCLUSIONS
  This low-cost, browser-based ultrasound simulator is easy-to-build, very adaptive, and independent from operating systems. It has the potential to facilitate POC-US training throughout the world, especially in resource-limited areas.
authors.affiliation: Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Domagoj
authors.initials: D
authors.lastname: Damjanovic
authors.affiliation: Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Goebel
authors.affiliation: Information Technology Section, Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany.
authors.forename: Benedikt
authors.initials: B
authors.lastname: Fischer
authors.affiliation: Information Technology Section, Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Huth
authors.affiliation: Information Technology Section, Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Breger
authors.affiliation: Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Buerkle
authors.affiliation: Department of Anesthesiology and Critical Care, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Strasse 55, 79106, Freiburg, Germany. axel.schmutz@uniklinik-freiburg.de.
authors.forename: Axel
authors.identifier: http://orcid.org/0000-0002-9744-5764
authors.initials: A
authors.lastname: Schmutz
keywords: Point-of-care systems; Simulation training; Ultrasonography