Using Ultrasound for Paracentesis

​Paracentesis can be a quick and simple procedure with the right equipment and a well-rehearsed approach. It's important to practice this skill in the procedure lab and to familiarize yourself with the kit in your department a few times a year. This month, we focus on paracentesis set-up and basics, and next month we will review the nuts and bolts of completing the procedure.Important equipment for paracentesis: Five or six collection bottles, antiseptic prep, and a paracentesis kit. Consider longer needles for abdominal walls thicker than 2.5 cm.Grab the ultrasound and a pen. Position your patient at a 45-degree angle, and begin scanning the abdomen. Find a colleague to help with this procedure because patients may become uncomfortable lying at that angle. You will also need help swapping out collection tubes and repositioning the patient. Rotate the patient slightly toward his side, and choose a left lateral approach for needle insertion. The procedure itself should be relatively painless once the anesthetic is administered.Using the curved linear probe, drop your hand almost flush with the stretcher and scan for fluid.Watch our video showing the basics of imaging and landmarks.Ultrasound can help lower the rate of complications, avoid solid organ or intestine puncture, and help identify which patients are best suited for paracentesis. You can use medial or lateral approaches to identify pockets of fluid in the safe zone, avoiding the epigastric vessels and bladder, t...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs