Cure Your Chronic Disease

Carotid Ultrasound Training

CureScreen: Get Started

Welcome to CureScreen. As a dedicated CureCoach Scanner, you've joined the Proactive Medicine movement. This page is your comprehensive guide to CureScreen carotid ultrasound , a vital first step to warn patients of serious threat to quality longevity.

You will find detailed instructions, step-by-step procedures, and best practices to get you started. Let's ensure you're equipped to deliver personalized and impactful care, embracing the future of Proactive Medicine with every CureScreen. Your dedication is key to shaping a healthier tomorrow for your patients.

Please review the following and watch the videos in the links provided to make the most of your CureScreen online training.


Order Gel

Recommended gel: Aquasonic 100 Ultrasonic Gel

If you do not have gel, hand sanitizer, hair gel, or other clear lubricants (or even water) can work. However, ultasound gel does not run or dry out as quickly as these other alternatives.


Get started with your Butterfly iQ ultrasound probe

Unbox your Butterfly probe: Click here for a video to “meet” your Butterfly device.

Charge your probe: Use the USB charging block that comes with the device to ensure reliable charging. Most charging issues happen when an alternative USB plug-in source is used.

Get to know the Butterfly iQ+ probe: Click here for a video introduction to the basics.

Ensure the mobile device you are using with the Butterfly has enough memory to store images: If you are using an older model with little memory, consider an upgrade. See Butterfly Compatible Devices

Connect your mobile device to a reliable WiFi or LTE or faster internet access. Slow or weak internet connection can lead to a more difficult imaging and download experience.

Screen sharing from computer and mobile device during online personal training: During online training, these skills come in quite handy. Click here for screen share meeting tips.

Connect to your CureCoach image archive: When you purchased your Butterfly Probe, a membership to your individual archive is required so that you can store images on your archive account for at least one year. CureCoach provides a CureCoach archive dedicated to CS@YourService. Everyone scanning in your service/practice will be assigned access to the CureCoach organization and to your dedicated archive. Click here to get acquainted with the Butterfly user interface and the CureScreen process: CureScreen steps on Butterfly iQ+.

Please send a list of email addresses of your scanners to drbacks@thecurecoach.com. Each will receive an email from Butterfly inviting them to create access to your archive with their email user name and password. CureCoach will then authorize them to access your CS@YourService archive as well as CSTraining Scans, which is a general archive where you can store images while practicing without incurring interpretation costs. Everyone needs their own access; please do not share log in credentials. This enables us to provide feedback directly where it needs to go and answer questions using the robust message platform built within the Butterfly user interface. Sharing log in credentials is also a violation of sound security and privacy policies.

The video overview below will help you get started with:

  • Choosing the correct…

    • Organization:

      • CureCoach for CureScreen carotid ultrasound and eventually Vasometric CIMT reports after experience and more training

      • Your Organization for other images you choose for your circumstances

    • Archive: CS@YourService

    • Preset: Vascular: Carotid

  • Scanning: Focus on Short Axis/Cross Section images till comfortable and confident; Record Video only; No still captures, please; Smooth steady slide from clavicle to chin and back to view common carotid, bifurcation (bulb) and internal/external carotid brances and back; pause on suspected plaque or inflammation thickened wall.

  • Saving images: 2 short axis views (RT and LT) per study

  • Labeling optional: RT or LT. If missing will assume that the first image is RT and the second is LT. For CureScreen, location is not relevant. Presence or absence of disease is the question to be answered.

  • Save as Draft to identify studies for interpretation and reporting by CureCoach


CureCoach Video Training

Watch the video below for an example of the one-on-one training we will provide via Zoom after you review this resource.

 

Perform a Scan

You can practice on yourself, but it is most helpful to practice on as many volunteers (staff, family, friends) as possible to gain experience, confidence and competence. You will also potentially alert them to a threat and opportunity to reduce their risk of harm from heart attack or stroke in the future.

Using the app on your Butterfly mobile device, choose the Carotid Vascular preset.

Take a “practice swing” short axis/cross section scan from clavicle to chin and back (common carotid to bifurcation/bulb to internal and external carotid branches) to swipe right/left to set gain (not too bright, not too dark) and swipe up/down to set depth (carotid cross section/short axis circle in the middle of the image) and identify suspected plaque/atheroma . The location of any identified plaque should be most centered and gain optimized.  Once recording starts, gain and depth can not be adjusted. If either need adjustment, just start over.

Repeat the scan while recording video. 10-15 seconds is a good goal, though you have up to 30 seconds. Go smoothly but don’t hurry. Pause and slide up and down on areas you suspect show plaque/atheroma. As a beginner, focus on getting comfortable and confident with short axis/cross section views showing the artery as a black circle. For long axis views (after you are confident with short axis views) image the intima media layer on the far wall for 3 beats. With more experience you can provide views of the internal carotid and anterior wall and plaque in the long axis view, but be patient and master the basics first.

Don’t bother taking still captures. The interpreter gets the needed information from the video review and can save still captures of findings from the video. Still captures add time, complexity and frustration, especially in the early experience. CureScreen is intended to be quick and simple. Master the basics before advancing to more challenging skills. Go slow and be patient. 🙂

Obtain Short Axis views, first on the patient right, then the left:

  1. Short Axis Right
    - CureScreen and Vasometric CIMT studies
    - Clavicle to chin (Common Carotid Artery to bifurcation/bulb to Internal Carotid Artery/External Carotid Artery) and back

  2. Advanced scanners only: Long Axis Right after you are comfortable with short axis scans of CureScreen protocol
    - Vasometric CIMT report enabled
    - Three pulsation beats with IMT visualized just proximal to bulb

  3. Short Axis Left
    - CureScreen and Vasometric CIMT studies
    - Clavicle to chin (CCA to bifurcation to ICA/ECA) and back

  4. Advanced scanners only: Long Axis Left after you are comfortable with short axis scans of CureScreen protocol
    - Vasometric CIMT report enabled
    - Three pulsation beats with IMT visualized just proximal to bulb

After scanning and saving the two short axis images for CureScreen (or four images for Vasometric CIMT report), find the image reel counter in the upper-right corner and click on the reel counter. Find “Archive to” at the top of the screen and choose the CS@YourService archive.

Please enter the following identifying information:

  • First & Last Name: Use legal first and last names (including hyphenated last names) as they appear on insurance cards and ID. Avoid nicknames or shortened names unless they are truly their legal name so that we can match images and reports with existing medical records.

  • Sex/Gender

  • Date of Birth

  • Patient ID is their personal Email address - we prefer personal, not work email because it is less subject to change. Be very careful to ensure accuracy as this is used as the patient ID to connect them on https://CureCoach.App to receive the report securely and privately. If they can’t provide a unique email address, leave it blank. If a couple shares an email address, only one CureCoach.App account will be created and all reports attached to that account.

    • Accession #: Cell phone # - preferably personal, not work. Please leave out dashes and (). Eample: 1234567890. If no cell phone is available, use a landline and mark with “LL” at the end

Swipe down to see the images. Click on the first image. Click Edit (upper right corner). Click Label Capture. Tap on Aa and choose RT for the first image and click Done and Save. Click the second image and repeat, choosing LT for the label and click Done and Save. Then click the X upper left corner to go back to the entry view.

Click “Save Study” in the blue bar at the bottom. Then, click “Save as Draft” (top button) and click “Confirm” in the bottom blue bar. (Saving as a “draft” makes it easier to identify studies i n need of interpretation and reporting.)


Image Processing and Report by CureCoach/Vasolabs

  • CureCoach reader determines if study shows definite plaque, inflammation, or no disease.

    • “Yes” if plaque is visible

    • “No” if plaque is not visible

    • “Possible” if inflammation is visible; we err on the side of reporting false positives to avoid missing disease and opportunity for early intervention.

    • Incomplete exam. If no disease is seen, but the entire carotid artery and branches are not imaged, the exam will be deemed incomplete and a repeat scan recommended at the earliest opportunity.

  • CureCoach provides a PDF CureScreen report with findings and recommendations for further actions and patient education. It also includes a deidentified link to the images.

  • Vasometric CIMT report option for more advanced scanners: If Long Axis views are provided and adequate for IMT measurement, images are sent to Vasolabs for Vasometric CIMT reports. Upon receipt of payment using this Vasometric CIMT Payment link, Vasolabs will provide the patient a link to their Vasometric CIMT report including arterial age, Intima Media Thickness, %ile rank and plaque character/thickness. The provider will have access to the reports via www.portal.vasolabs.com

  • CureCoach creates a CureCoach.App record for each scan/patient. Reports and recommendations are attached to Results and Recommendations in CureCoach.App for the provider and patient to review. An email will be sent to the patient, inviting them to register and view their results.

    • If a patient requests the report be emailed, they are informed that this method is less secure and private. However, we will send via email if the patient declines to register for CureCoach.App and assumes the privacy and security risk.

    • We do not use postal mail due to administrative costs and difficulty tracking/ensuring receipt of materials.

Video Discovery appointment

After the patient reviews their report, we offer a video Discovery Appointment (no cost,no obligation) to review their images and describe the next steps, including cost, insurance coverage and scheduling. At that time, payment will be received and images sent for the Vasometric CIMT report if the images are adequate.

Here is a Video Discovery Appointment example. Scheduling and completion of registration documents is done here.


Suggested Script for Scanners (Written/Verbal)

“Atherosclerosis kills and disables more adults than any other disease. We are giving you a chance to avoid a stroke or heart attack.

Inflammation of the gums and dental abscesses contribute to atherosclerotic plaque that ruptures in the arteries to your brain, heart and other vital organs.  Plaque is like an acne pimple in the wall or skin of your arteries.  It can heal and resolve. Or it can rupture.

Sudden plaque rupture leads to a stroke or heart attack, disability or death.  But this can be prevented if you know about it and act to stop it.

Like a pap smear or PSA, early detection and treatment saves lives.

With this quick, painless, radiation and risk free ultrasound scan of the carotid arteries in your neck, we can see if this threat is developing silently.  It is safe enough to see inside pregnant women and babies. 

After I scan, the images are reviewed by an experienced interpreter for completeness looking for plaque.  If plaque or inflammation is reported, you can schedule a consultation with experts who know how to get rid of the threat to your life and wellbeing.

We scan at no cost, but for only $99 you can get a report telling you if you have the reversible and even curable disease that kills and disables more family and friends than any other condition, including cancer. 

This includes an opportunity to discuss your scan on a Discovery Video Call and learn about options most doctors can’t offer. The cost is surprisingly affordable, including coverage by Medicare and most insurance.

If your arteries are free of plaque or inflammation, you get reassurance.  Check again in a year or 2, just like checking your blood pressure or screening for cancer.

You have nothing to lose!  This proactive step can save your life. You are worth it.”


Questions?

Email Dr. Craig Backs at drbacks@thecurecoach.com, text 217-717-6069 or call 217-321-1987 during office hours.