Journal article
Emergency Physician Performed Ultrasound-Guided Abdominal Paracentesis: A Retrospective Analysis
POCUS journal, Vol.9(1), pp.75-79
04/22/2024
DOI: 10.24908/pocus.v9i1.16668
PMCID: PMC11044928
PMID: 38681156
Abstract
Background: Emergency physicians commonly perform ultrasound-assisted abdominal paracentesis, using point of care ultrasound (POCUS) to identify ascites and select a site for needle insertion. However, ultrasound-guided paracentesis has the benefit of real-time needle visualization during the entire procedure. Our objective was to characterize the performance of emergency physician-performed ultrasound-guided paracentesis using POCUS, their ability to achieve good in-plane needle visualization, and factors associated with procedural success. Methods: A POCUS database was retrospectively reviewed for examinations where abdominal paracentesis was performed by an emergency physician at two academic urban emergency departments over a six-year period. Medical records were reviewed for demographics, presenting history, complications, and hospital course. Descriptive statistics were used to summarize the data. Results: 131 patients were included in the final analysis. The success rate for ultrasound-guided paracentesis was 97.7% (84/86 [95% CI: 92-100%]) compared to 95.6% (43/45 [95% CI: 85-99%]) for ultrasound-assisted paracentesis (p=0.503). 58% (50/86) demonstrated good in-plane needle visualization; 17% (15/86) had partial or out-of-plane visualization; and 24% (21/86) did not demonstrate needle visibility on their saved POCUS images. All four procedural failures were performed by first- or second-year residents using a curvilinear transducer, while all procedures using a linear transducer were successful. The most common complications were ascites leak, infection at the site, and minor bleeding. Conclusions: Emergency physicians with training in real-time needle guidance with ultrasound were able to use POCUS to perform ultrasound-guided paracentesis in the emergency department with a high success rate and no fatal complications. Based on our experience, we recommend performing ultrasound-guided paracentesis using a linear transducer, with attention to identifying vessels near the procedure site and maintaining sterile technique.
Details
- Title: Subtitle
- Emergency Physician Performed Ultrasound-Guided Abdominal Paracentesis: A Retrospective Analysis
- Creators
- Brandon M Wubben - University of IowaJad Dandashi - University of ArizonaOmar Rizvi - University of ArizonaSrikar Adhikari - University of Arizona
- Resource Type
- Journal article
- Publication Details
- POCUS journal, Vol.9(1), pp.75-79
- Publisher
- CINQUILL Medical Publishers Inc
- DOI
- 10.24908/pocus.v9i1.16668
- PMID
- 38681156
- PMCID
- PMC11044928
- ISSN
- 2369-8543
- eISSN
- 2369-8543
- Language
- English
- Date published
- 04/22/2024
- Academic Unit
- Emergency Medicine
- Record Identifier
- 9984618625902771
Metrics
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