Reflections on piloting an advanced practitioner led domiciliary paracentesis service for end-of-life patients in a rural setting

This reflection details how the purchase of a small portable ultrasound system enabled a pilot domiciliary paracentesis service. The service offers symptom relief through ascitic drainage to palliative, end-of-life, patients who wish to avoid a hospital admission. Identifying appropriate patients and considering risk, the service is offered and supported by appropriately trained advanced practitioners along with palliative, oncology and district nursing teams. A small number of patients have been involved, but anecdotally, this has offered great relief and comfort to both the patients and their families. The ongoing aim is continue offering this service and make more community teams within our area and beyond aware of its existence and to support the training of interested and skilled palliative health care professionals in performing these.