Ride the Fluid Wave Before Performing a Paracentesis

​Before you break out the bottles for a paracentesis, you may want to consider doing a test for ascites. Many procedures require executing an old-school test before even looking at a result or grabbing an ultrasound machine. Knowing what to look for on a physical exam may guide your practice and intervention dramatically. Using noninvasive tools first could help your patient avoid other tedious or unnecessary testing, which may also result in lost time. Incorporating ultrasound into your practice may also help you nail a diagnosis or allow you to perform a procedure better than you expected.A markedly distended abdomen due to ascites. The abdominal cavity may contain many liters of fluid.Laying your hands on a patient's abdomen is still one of the best ways to help make an accurate diagnosis. This is true of such tests as deep pressure applied to the right lower quadrant to help rule out an appendicitis, which is about 91% sensitive (Shackelford's Surgery of the Alimentary Tract, Eighth Ed. Philadelphia: Elsevier; 2019), or deeply palpating the right upper quadrant to check for cholecystitis, which is about 97% sensitive. (J R Coll Surg Edinb. 1996;41[2]:88.) The fluid wave and fluid thrill tests have been used for years to check for ascites or free fluid in the abdomen. They are our tests of choice to perform before setting up for paracentesis, though a fluid wave is a more specific but less sensitive finding.The Cause of AscitesAscites can be caused by many disease proces...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs

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