Jessie Childs

Ultrasound measurements of the liver: an intra and inter-rater reliability study

Introduction: Ultrasound is an easy and inexpensive method to rapidly assess the size of the adult liver. The literature addressing reliability of liver measurements using ultrasound is poorly reported and inadequate. In this study, intra and inter‐rater reliability of multiple measurements of the right lobe, left lobe and entire adult liver were assessed.

Methods of Determining the Size of the Adult Liver Using 2D Ultrasound A Systematic Review of Articles Reporting Liver Measurement Techniques

Sonography is an effective, noninvasive, safe, and inexpensive technique for measurement of the liver. Measurements of the liver using 2D ultrasound aid in diagnosing and tracking liver disease and in surgical planning. Multiple studies have developed techniques to measure the adult liver using 2D ultrasound. The aim of this systematic literature review was to determine whether a correctly developed, reliable, and reproducible technique for measuring the liver using 2D ultrasound has been reported. Analysis of studies meeting the inclusion criteria showed that none of these studies has been rigorously undertaken in terms of sample size justification, validity, reliability, and/or statistical analysis.

Measurement of vein diameter for peripherally inserted central catheter (PICC) insertion: an observational study

Choosing an appropriately sized vein reduces the risk of venous thromboembolism associated with peripherally inserted central catheters. This observational study described the diameters of the brachial, basilic, and cephalic veins and determined the effect of patient factors on vein size. Ultrasound was used to measure the veins of 176 participants. Vein diameter was similar in both arms regardless of hand dominance and side. Patient factors—including greater age, height, and weight, as well as male gender—were associated with increased vein diameter. The basilic vein tended to have the largest diameter statistically. However, this was the case in only 55% of patients.

Ultrasound in the assessment of hepatomegaly: A simple technique to determine an enlarged liver using reliable and valid measurements

Knowledge of the size of the liver is an important factor in diagnosing liver disease. Hepatomegaly is a term used to describe a liver that is enlarged beyond its normal dimensions, and ultrasound is often a front line investigation in the suspicion of hepatomegaly. This study sought to develop a reference range for the size of the normal liver using a simple, reliable and valid measurement technique.

What are the perceptions of women towards transvaginal sonographic examinations

Sonographers in Australia commonly perform transvaginal sonography (TVS) as part of routine practice. Sonographers require guidelines for best practice when performing TVS examinations to enable patient satisfaction and best healthcare outcomes and to minimise risk of complaints and litigation, which may arise due to the intimate nature of the examination. We performed a literature review to provide insight into the perceptions of women who have experienced a TVS. Six studies were identified, which explored the perceptions of women who had undertaken a TVS. This review identifies strategies that may have contributed to high acceptance rates of TVS. The findings of the review were inconclusive in determining womens preferences for male or female TVS examiners and revealed that guidelines encouraging sonographers to have a chaperone when they perform TVS appear to be in conflict with womens preferences.

Are Ultrasound Measurements of Achilles Tendon Size Reliable? A Systematic Review of Rater Reliability

Ultrasound measurements of Achilles tendon size are used to assess the tendons response to exercise, aging, rehabilitation, tendon loading and healing. It is important to understand and minimise the measurement error that occurs with these measurements. This review identified and synthesised studies reporting on intra- and inter-rater reliability of ultrasound measurements of Achilles tendon size. Analysis of 21 studies revealed that good to excellent intra- and inter-rater reliability can be achieved for ultrasound measurements of Achilles tendon size. Reliability can be optimised by using one experienced operator, standardising transducer pressure and orientation and averaging two or three measurements. There was a high risk of methodological bias across the included studies. Reporting of reliability studies needs to be improved by the use of existing reporting guidelines and expansion of these guidelines to include important elements of ultrasound imaging.

Safety of ultrasound exposure: knowledge, attitudes and practices of Australasian sonographers

Introduction: While perceived as safe, diagnostic ultrasound has the potential to cause biological effects on the body tissues. The aim of this study was to evaluate knowledge, attitudes, and practices of Australasian sonographers on bioeffects and safety of ultrasound scanning. Methods: Focus groups were used to develop a questionnaire to explore knowledge, attitudes, and practices of ultrasound safety, which was then distributed to Australasian sonographers. Thematic (focus groups) and descriptive (questionnaires) analyses were undertaken. Results: A 37-item questionnaire addressed knowledge, attitudes, and practices of ultrasound safety. In 47 collected responses, sonographers demonstrated good familiarity of thermal index (TI) (79%), mechanical index (MI) (68%), and “as low as reasonably achievable” (ALARA) principle (85%). However, most sonographers could not accurately define TI (13%) and had poor knowledge of safety guidelines relating to TI (19%) and MI (14%). Over 30% were uncertain about their attitudes to ultrasound safety issues. While 52% always and 30% most of the time adhere to ALARA, 37% of sonographers reported never monitoring TI and MI. Discussion: While familiar with safety terms, knowledge of safety guidelines was lacking. Many sonographers were uncertain about their attitudes to the safety of scans, and safety practices involving monitoring for bioeffects were not a high priority.

The effect of oral hydration and localised heat on peripheral vein diameter and depth: A randomised controlled trial

BACKGROUND Accessing the peripheral veins for blood sampling and short-term peripheral intravenous catheter insertion is common in contemporary healthcare. Clinicians may apply heat or promote oral hydration to increase vein diameter and reveal veins to improve success rates. However, there is limited research that has examined the effect of these interventions on vein diameter and depth. OBJECTIVES To determine the effect of localised heat and oral hydration on vein diameter and depth. DESIGN A three arm parallel randomised controlled trial was undertaken with 39 healthy participants from a University. All participants fasted from food and fluid from midnight. At 10 am the next day, a mark was made at the cephalic (120 mm proximal from the radial styloid) and median cubital veins (at cubital fossa) with non-permanent ink and participants underwent baseline vein diameter and depth measurement using ultrasound. Participants were randomised to either a control, heat or hydration group. Participants in the hydration arm consumed 1 L of room temperature tap water, those in the heat group had a wheat bag applied to the area for 10 min and those in the control group had no intervention and were asked to sit quietly. A second measurement was undertaken immediately after the heat intervention and 1 h after the baseline measurement for those in the hydration and control groups. RESULTS The application of localised heat and oral hydration did not affect the depth of the cephalic vein. Whilst hydration had no effect on median cubital vein depth, the application of heat did make this vein more superficial compared to the control group (p = 0.033). The application of heat resulted in a statistically significant (p = 0.006) increase in cephalic vein diameter compared to the control group, this effect did not occur with the median cubital vein (p = 0.087). Oral hydration resulted in a reduction in the mean diameter of both veins. Compared to the control group, the average median cubital vein diameter decreased by 0.57 mm (p = 0.003; 95% CI -0.940 to -0.193) and the cephalic vein reduced by 0.33 mm (p = 0.015; 95% CI -0.593 to -0.064) after oral hydration. CONCLUSION The use of localised heat was inconsistent in its effect on vein diameter and depth. Oral hydration caused a reduction in vascular calibre in both the cephalic and median cubital veins. The promotion of water consumption to improve venepuncture success is not supported.

Safety of ultrasound exposure: Knowledge, attitudes and practices of Australasian sonographers

While perceived as safe, diagnostic ultrasound has the potential to cause biological effects on the body tissues. The aim of this study was to evaluate knowledge, attitudes and practices of Australasian sonographers on bioeffects and safety of ultrasound scanning.

Transvaginal sonography: Sonographer reflections on patient experience using a critical incident technique

It is important to understand patient experiences of transvaginal sonography (TVS) due to its intimate nature and potential for patient discomfort. This may place the sonographer at increased risk of complaints and litigation due to misunderstandings and unfulfilled patient expectations.