Comparison and Efficacy of Food Powder Reconstitutions for Ultrasound Gel Application in the Resource-Limited Environment

IntroductionPortable ultrasound enhances medical assessments in austere environments but is often limited by volume, weight, and availability of commercial gels. This study evaluates the stability and image quality of powder-based ultrasound gel substitutes.MethodsEight alternative gel formulations were compared with commercial gel across simulated environments: tundra, desert, altitude, and hospital control. Gels were assessed daily for color, viscosity, odor, homogeneity, and tensile strength. A stability score was calculated and analyzed using ANOVA with Tukey's HSD. Ultrasound images of the internal jugular vein, lung, hepatorenal recess, and quadriceps tendon were obtained using SonoSite and Butterfly devices. Blinded ultrasound-trained faculty graded the image quality (1-10), with t-tests comparing alternatives to control (<i>p</i> < 0.05 significant).ResultsAll alternatives degraded over 1 week. ANOVA confirmed significant effects of gel type (<i>p </i>< 0.0001) and time (<i>p</i> < 0.0001), with Tukey's HSD identifying dry commercial and xanthine as most stable.ConclusionSonosite, cassava (<i>p</i> = 0.05), and dry commercial (<i>p</i> = 0.02) outperformed the control at the internal jugular, while tapioca (<i>p</i> < 0.00), cornstarch (<i>p</i> = 0.01), and water (<i>p</i> < 0.00) performed worse at the hepatorenal. At the quadriceps, cassava (<i>p</i> = 0.01), cold glucomannan (<i>p</i> < 0.00), guar gum (<i>p</i> = 0.01), cornstarch (<i>p</i> = 0.04), and water (<i>p</i> < 0.00) performed worse. Using Butterfly, cold glucomannan (<i>p</i> = 0.02), guar gum (<i>p</i> = 0.01), tapioca (<i>p</i> = 0.02), cornstarch (<i>p</i> = 0.01), and water (<i>p</i> < 0.01) performed worse at the hepatorenal, while at the quadriceps only water (<i>p</i> = 0.02) performed worse.