Assessing the utility of ultrasound in the role 2 hospital setting

The usefulness of departmental diagnostic ultrasound in the role 2 setting has not been previously evaluated. This is because role 2 hospital manning does not traditionally include a diagnostic radiologist. This study aims to evaluate the usefulness of this added capability in the deployed role 2 hospital setting.

Prospective data were collected using a questionnaire alongside each scan request during the Op TRENTON 3 operational period. This included details of clinical indication and presumptive diagnosis. Scans were acquired and reported as part of routine care. The postscan clinical diagnosis and effect on management plan were determined by the treating clinician and recorded on the questionnaire. Point-of-care and focused assessment with sonography in trauma scans were excluded, as were ultrasound-guided interventional procedures.

41 diagnostic departmental scans were included over the six-month period. 68% (28/41) of the scans increased clinical confidence in the management plan, while 29% (12/41) led to an alteration in the management plan. Only one examination (3%) was deemed to have had no clinical impact. Overall, the musculoskeletal scans had the greatest impact on patient management.

Constraints of manoeuvrability at role 2 currently preclude the availability of body CT and shift the demand for diagnostic soft tissue imaging to ultrasound. This capability is only possible with the deployment of suitably trained individuals. This study highlights the utility of this capability at role 2. Musculoskeletal ultrasound skills were of particular value, and training should be encouraged among physiotherapists and radiographers in lieu of, where necessary, a suitably trained deployable radiologist.