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aaa.screening.nhs.uk National programme website – aaa.screening.nhs.uk
Abdominal Aortic Aneurysm
Five Rivers AAA Screening ProgrammeReview of Non-Visualised Scans
Caroline Wells (Programme Manager)March 2016
aaa.screening.nhs.uk
Overview• National guidance• Local and national performance• Review of 2014/15 and 2015/16 data
– By machine– By user– Reasons for non-visualisation
• Conclusions
aaa.screening.nhs.uk
National guidance• NAAASP requires both TS
and LS aortic measurements for the screening test to be classed as successful
• If any part of the infrarenal aorta cannot be visualised it should be recorded as a non-visualised scan
NAAASP (2014) Non-visualised aortas: Guidance for local AAA screening programmes in the management of non-visualised screening results
aaa.screening.nhs.uk
National guidance
Reasons for non-visualisation include:•High body mass index•Excessive bowel gas •Ambiguity regarding calliper placement and aortic diameter measurement•Unusual anatomy or pathology
aaa.screening.nhs.uk
National guidance
NAAASP (2015) Pathway Standards for NHS Abdominal Aortic Aneurysm Screening Programme
Standard 9 •Percentage of screening encounters where aorta could not be visualised
Rationale•A high non-visualised rate may be due to a training issue, equipment maintenance issues or it may be a reflection of the population being screened
aaa.screening.nhs.uk
Performance
Five Rivers AAA Screening Programme•Increase in the number of non-visualised scans over the last year:
– 0.53% in 2014/15 (21 scans)– 1.16% up to the end of Q3 2015/16 (28 scans)
•Nationally:– 1.41% of scans were non-visualised in 2014/15– 1.39% up to the end of Q3 2015/16
•Thresholds: Acceptable ≤ 3% Achievable ≤ 1%
aaa.screening.nhs.uk
Number of non-visualised scans by machine(as a percentage of total scans completed per machine)
Sonosite machines in use since April 2012Green and blue systems were replaced in April 2014
aaa.screening.nhs.uk
Number of non-visualised scans by user(as a percentage of total scans completed per Screening Technician)
aaa.screening.nhs.uk
Conclusions• No obvious pattern with equipment or user
• It may be possible to minimise the number of non-visualised scans due to bowel gas – Use of techniques such as breathing exercises and
movement to help move the gas– Further analysis of possible causes of bowel gas e.g.
medication