Characterization of a hepatic haemangioma with contrast-enhanced ultrasound in an infant.

Focal liver lesions are uncommon in the paediatric population, majority are benign but need to be clearly identified as benign. Contrast-enhanced ultrasound has recently received approval for paediatric hepatic use and represents an inexpensive and safe alternative to computed tomography and magnetic resonance imaging for focal liver lesion characterization. We report a case of an incidental focal liver lesion in a four-month-old infant, indeterminate on B-mode ultrasound but successfully characterized with contrast-enhanced ultrasound as a haemangioma, without recourse to other imaging techniques, and with minimal patient discomfort.

Post Brexit: challenges and opportunities for radiology beyond the European Union.

We aimed to review the challenges and opportunities that radiology may face once the UK leaves the European Union (EU). Even before the exit negotiations commence, uncertainty over future policies and funding within the UK may influence the National Health Service (NHS). We discuss the potential impact that financial, regulatory and social changes may have on healthcare, and radiology in particular. Current difficulties in recruitment and retention of radiologists and the challenges that Brexit present are considered. Uncertainty over the new immigration regulations and their impact on the NHS workforce is addressed. Challenges also apply to UK research, which has greatly benefited from EU funding and the free movement of staff. Appreciating the problems as well as the opportunities that Brexit presents will help prepare radiology in the UK for the next decade.

Improving Peripherally Inserted Central Catheter (PICC) care on a Trauma and Orthopaedics ward.

Peripherally Inserted Central Catheter (PICC) blockage rate was audited over a two month period on the Trauma & Orthopaedics ward at our District General Hospital. A 70% (five out of seven) PICC blockage rate was observed. High blockage rates lead to potential treatment complications, delays in delivery of treatment, increase in costs, and reduction in patient satisfaction. The factors contributing to the significant blockage rate include, long and contradictory PICC care guidelines, no information sheets in the patient notes, lack of training and awareness about care of, and flushing of, PICC lines, and lack of accountability for PICC flushing. Our project aimed to achieve a greater rate of PICC patency. We produced one succinct and comprehensive PICC care guideline, carried out staff training sessions, introduced a sticker reminding staff to flush the PICC line after use, and introduced a prescription of weekly heparin saline and PRN saline flushes (for monitoring and accountability). We used questionnaires to assess competency of hospital staff pre-teaching (doctors 6%, nurses 0%), and post-teaching (doctors 70%, nurses 38%). Blockage rate data post-intervention is pending. Education improved awareness of guidelines amongst staff and we anticipate that the proposed interventions will translate into reduced blockage rates, improving patient outcomes and reducing costs.