Background Ultrasound imaging is increasingly being used by non-radiologists. The Focussed Abdominal Ultrasound in Palliative Care (FASP) course trains palliative care clinicians in the use of ultrasound to answer certain focussed clinical questions.
Method Analysis of an electronic database detailing all scans performed at the hospice between April and September 2017.
Results Over the 6 months 44 ultrasound scans were performed at the hospice on 35 patients. 25 scans were performed to confirm the presence of ascites or identify a safe site for paracentesis, 8 of these were for non-malignant ascites. 8 scans assessed for bladder enlargement or requirement for a catheter, 1 scan was to distinguish between intrahepatic and extrahepatic duct dilatation in a jaundice patient and 10 doppler ultrasounds were carried out to look for the presence of a proximal lower leg deep vein thrombosis. 24 of these ultrasound examinations would have otherwise required patient transfer to nearby hospital for the investigation. During the analysis period only 3 patients were transferred to hospital for ultrasound; one whilst author was on leave and two where further ultrasound assessments by a radiologist was deemed necessary. Using tariffs from the Welsh Ambulance Service and Health Board it is calculated, that in the 6 month period analysed, savings of £4435 were made through a reduction in return ambulance transfers and ultrasound scanning at the nearby DGH.
Conclusions The use of ultrasound as an additional real-time resource in clinical assessment at the hospice reduced unnecessary hospital transfers and needless urinary catheterisations. Positive feedback received from patients and relatives grateful for the rapid assessment and avoidance of what were described as exhausting and stressful transfers. Other members of the medical and nursing team at the hospice now plan to attend a FASP course.
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