According to Dr Judith McEniery, medical staff use the Vscan to undertake an immediate assessment of patients at the bedside, enabling the palliative care team to operate independently of the X-ray department although on some occasions, the treating physician has made the decision to use both.
“I have been able to satisfactorily identify the appropriate drainage site for pleural effusion and ascites in a number of patients on numerous occasions, saving patients from going to the X-ray department. According to our records, only about one in 10 still proceeds to a formal ultrasound,” Dr McEniery said.
“I think it is reassuring for patients to know that the doctor can reassess them at the time of the drainage procedure. It’s quick and easy and doesn’t produce any discomfort for the patient whatsoever,” she said.
“I’ve had some people who wish to see the image of what is causing their pain and their apprehension can be allayed by seeing the fluid inside their chest or abdominal cavity. We can then easily insert a needle and withdraw the fluid.”
A condition such as ascites can impact a patient’s quality of life. One patient with carcinoma of the breast, also developed metastatic involvement of the lungs and abdomen and over a few months, developed a problem with gross ascites. Prior to the condition developing, she had been able to move around but the large collection of fluid in her abdomen, caused pain and great discomfort and prevented her from getting out of bed.
By using Vscan at the patient’s bedside, the procedure was undertaken quickly and easily without the patient having to be moved. After a fluid drainage, the patient was much more comfortable and able to move from bed to chair. She was also able to eat more easily because her abdomen was not so swollen and tense. By using Vscan, the medical team can visualise what they feel and hear with traditional palpation or auscultation techniques.
In addition to assessing fluid drainage sites, the medical team have also used Vscan to elucidate complicated situations such as finding undiagnosed hydro-nephrosis on one patient. In another instance, the liver metastasis was clearer on the ultrasound than on CT. On other occasions, the medical team have used the Vscan to scan a patient’s bladder when a bladder scanner was not available on the ward.
Typically, the medical team have used Vscan to minimise the number of additional procedures required by their patients. These have included chest X-rays for patients with recurrent pleural effusion or the need for a formal ultrasound in the management of ascites.
“It has become a nice adjuvant to my care,” Dr McEniery said.