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Ultrasound technology helps chemotherapy patients

Donations have funded an innovative form of ultrasound technology that is improving patients' experience of chemotherapy

The Sherlock 3CG™ machine was trialled at King’s College Hospital last year, and is now being used to help insert PICC lines and cannulas into cancer patients more effectively, reducing some of the side effects of these procedures. Patients who benefit from this technology experience more comfortable treatment and are able to receive treatment more quickly. 

PICC lines are a semi-permanent long and thin, hollow tube that can be fitted into a patient’s arm in order to transfuse a chemotherapy drug intravenously. The line is often left in there for several months until a patient finishes his or her treatment.

The technology helps doctors to find blood vessels more easily and eliminates the need for an x-ray, reducing both patient and doctor's exposure to harmful radiation. 

‘It’s almost like a “sat-nav” device because the end of the PICC has a magnetic tip so the machine is able to see where the PICC is going and can confirm the location,' explains Kevin Saltmarsh, Lead Chemotherapy Nurse at the Chemotherapy Unit in King’s (pictured below). ‘When using the machine, I can actually pinpoint exactly where the tip should sit, just above the heart.’

Revolutionising treatment

‘Without the Sherlock technology you’re essentially putting the PICC in blind and because people’s anatomies are very slightly different, you could inadvertently place the PICC in the incorrect position,’ says Kevin. ‘Or it can be far too short which then means you have to go through the whole procedure again to cut a new PICC to the right length – so there’s actually less wastage of products using this new system.’

Kevin has worked in the Chemotherapy Unit at King’s for 17 years so has witnessed first-hand how much chemotherapy treatment has developed and improved over the years. ‘This technology means that we do not require chest X-rays as part of the process to confirm the PICC location therefore we no longer have to expose people to unnecessary radiation. It also drastically reduces the cost because we’re not using these extra facilities and it’s a better patient experience because the machine is mobile and can be used anywhere – on the ward or at the patient’s bedside rather than in a sterile theatre room,’ says Kevin. 

Many of the patients have already been treated in the Chemotherapy unit and so are familiar with the staff and the environment where they are having the PICC procedure done. ‘It can be quite anxiety provoking for them if they then have to get an X-ray somewhere else,’ he says. Despite some patients feeling anxious about trying the new PICC line system, the feedback so far has been extremely positive.

Protecting the patient

As well as enhancing the safety and accuracy of the procedure, the new technology actually helps to preserves people’s limbs. ‘Unfortunately some patients going through chemotherapy will suffer damage to their limbs as the drug can strip the inner lining of the vessel, causing hardening of the veins which makes them almost impossible to use in the future,’ says Kevin.

‘This can cause long term problems with a patient’s dexterity – even for just doing up buttons or stretching their arms. In severe cases people have ended up with permanent damage whereas ultrasound technology should actually prevent that by improving the accessibility and visibility of the vessel,’ he says.

These benefits of using ultrasound similarly apply to inserting temporary devices such as a cannula, usually fitted into a patient’s hand or arm to transfuse drugs. Donations have enabled the unit to buy a Prevue™ ultrasound cannulation machine. ‘Nurses usually just rely on touch and sight to see where the cannula should be put in, whereas the ultrasound can see much deeper, allowing the use of bigger cannulas which causes less trauma to the veins,’ says Kevin.

So that more people can benefit from this effective technique, Kevin is currently training other members of staff on the unit to use the technology. In turn, he hopes the new systems will reduce waiting lists and speed up the process of discharging patients. ‘People want their treatment when it’s booked and if you have multiple attempts at a PICC line or cannulation there’s a risk that you have to delay it because it might be the only arm that you can use – and potential blood clots can occur,’ he says.

Long-term investment

The Prevue™ ultrasound technology for cannulation cost £7500 to purchase and the ultrasound Sherlock 3CG™ for PICC lines cost nearly £18000 but as Kevin explains, these costs can be recouped by making the process more efficient and effective. The machinery is fairly cheap for the hospital to run and maintain, which means it can eventually be made more widely available to patients.

Following its success in the Chemotherapy unit, this technology is starting to be trialled in other medical departments including the Intensive Care Unit (ICU) and Paediatrics, as it particularly helps with fitting cannulas into much smaller veins. Kevin is also currently helping to roll out these new systems in the Princess Royal University Hospital in Orpington.

‘The funding has enabled us to demonstrate to the NHS that these are valuable pieces of equipment so they can hopefully be fully funded in the future. We don’t want to be trapped in time where we’re slightly behind; we want to be forward thinking and moving the service forward,’ says Kevin.

‘This technology has proven to have huge benefits to patients and without donations we could not have gained the funding for the machinery. It’s been a really valuable investment because it has dramatically improved the patient’s experience and that is fundamental.’

Support revolutionary technology like the Sherlock 3CG™ machine by donating to King's College Hospital