Handheld Ultrasound (HHUS): Potential for Home Palliative
                    Care

Hendra Lo; Nicole Eder; David Boten; Christian Jenssen; Dieter Nuernberg

doi:10.1055/a-1999-7834

Ultrasound International Open, Table of Contents

CC BY-NC-ND 4.0 · Ultrasound Int Open 2022; 08(02): E68-E76
DOI: 10.1055/a-1999-7834

Review

Handheld Ultrasound (HHUS): Potential for Home Palliative Care

Hendra Lo

¹Brandenburg Medical University Theodor Fontane, Institute for Clinical Ultrasound (BICUS) and Faculty of Health Sciences Brandenburg, Neuruppin, Germany

²Department of Internal Medicine – Gastroenterology, Diabetology and Hepatology, Vivantes Hospital Neukölln, Berlin, Germany

,

Nicole Eder

¹Brandenburg Medical University Theodor Fontane, Institute for Clinical Ultrasound (BICUS) and Faculty of Health Sciences Brandenburg, Neuruppin, Germany

³Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg, Germany

,

David Boten

¹Brandenburg Medical University Theodor Fontane, Institute for Clinical Ultrasound (BICUS) and Faculty of Health Sciences Brandenburg, Neuruppin, Germany

,

Christian Jenssen

¹Brandenburg Medical University Theodor Fontane, Institute for Clinical Ultrasound (BICUS) and Faculty of Health Sciences Brandenburg, Neuruppin, Germany

³Department of Internal Medicine, Krankenhaus Märkisch Oderland, Strausberg, Germany

,

Dieter Nuernberg

¹Brandenburg Medical University Theodor Fontane, Institute for Clinical Ultrasound (BICUS) and Faculty of Health Sciences Brandenburg, Neuruppin, Germany

› Author Affiliations

Abstract

Due to the severity of their disease, palliative care patients often present complex clinical symptoms and complaints like pain, shortness of breath, nausea, loss of appetite, and fatigue. Solely relying on the information available from the history and physical examination often causes uncertainty among palliative care physicians regarding treatment decisions during home visits, potentially leading to unnecessary hospitalizations or transfer to cross-sectional imaging in radiological practices. A rational approach is essential to avoid diagnostic aggressiveness while still providing the imaging information required for optimal palliative care. Bedside use of handheld ultrasound (HHUS) has the potential to expand the diagnostic and therapeutic spectrum in the case of symptom exacerbation but is still underutilized. In this review, we evaluate the potential uses of HHUS in home care settings to provide a more accurate diagnosis of the most common symptoms in palliative patients and to guide bedside interventions such as bladder catheterization, thoracentesis, paracentesis, venous access, and regional anesthesia. Specific training programs for ultrasound in palliative care are currently not available. Adequate documentation is warranted but fraught with technological and privacy issues. Expert supervision and quality assurance are necessary. Despite its limitation and challenges, we suggest that HHUS leads to improved clinical decision-making, expedited symptom relief, and reduced complications without burdening of the patient and costly transfer to hospital or specialty consultations.

Key words

ultrasound, methods & techniques - pocus - outpatient care - handheld ultrasound - palliative care medicine

Full Text

References

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