title: The use of bedside ultrasound and community-based paracentesis in a palliative care service.
abstract: BACKGROUND
  There is little information, particularly in New Zealand, on the use of ultrasound to enhance clinical decision-making in a specialist palliative care service. Technological advances have resulted in increasingly portable, user-friendly ultrasound machines that can be used in the home setting to offer convenient access to this treatment option.
  
  
  OBJECTIVE
  To evaluate the clinical use of portable ultrasonography in the management of abdominal ascites in a community palliative care service.
  
  
  METHODS
  Patients referred to the Nurse Maude Hospice and Palliative Care Service requiring assessment for abdominal ascites over 12 months were scanned using a newly purchased handheld ultrasound machine. The patients had a variety of diagnoses; the most common diagnosis was ovarian cancer.
  
  
  RESULTS
  Forty-one ultrasound scans performed for 32 patients to assess for ascites drainage were recorded. Fluid was identified in 19 assessments and drainage undertaken in 17. Over half the scans were completed at home, allowing nine procedures to be performed safely and conveniently, which reduced time spent at the local hospital. There were no major complications.
  
  
  CONCLUSIONS
  Ultrasonography is a tool that has not previously been utilised in palliative care locally, but has significant potential patient benefits. This novel use of technology also highlighted potential cost savings to the patient and health system, which may be beneficial to other palliative care services in New Zealand.
authors.affiliation: Nurse Maude Hospice Palliative Care Service, PB 36-126, Christchurch, New Zealand. amandal@nursemaude.org.nz.
authors.forename: Amanda
authors.initials: A
authors.lastname: Landers
authors.affiliation: Nurse Maude Hospice and Palliative Care Service, Christchurch, New Zealand.
authors.forename: Bridget
authors.initials: B
authors.lastname: Ryan
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging; D001201:Ascites / Q000628:therapy; D003153:Community Health Services; D006801:Humans; D009520:New Zealand; D010166:Palliative Care; D019152:Paracentesis; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D014463:Ultrasonography / Q000706:statistics & numerical data*