Recommendations on the use of ultrasound guidance for adult lumbar puncture: a position statement of the Society of Hospital Medicine
| Autor: | Jeff Bates, Nitin Puri, Venkat Kalidindi, Benji Matthews, Nilam J. Soni, Kreegan Reierson, Joshua D. Lenchus, Satyen Nichani, Loretta Grikis, Joel Cho, Elizabeth K. Haro, Vicki E. Noble, Martin G Perez, Richard Hoppmann, Anjali Bhagra, Michael Mader, Nick Marzano, Vivek S. Tayal, David M. Tierney, Sophia Chu Rodgers, Ketino Kobaidze, Josh Lenchus, Michael Blaivas, Kirk T. Spencer, Robert Arntfield, Daniel J. Brotman, Mahmoud El Barbary, Susan Hunt, Ria Dancel, Saaid Abdel-Ghani, Trevor Jensen, Brian P. Lucas, P. Trevor, Ricardo Franco-Sadud, Aliaksei Pustavoitau, Ricardo Franco, Gerard Salame, Daniel Schnobrich, Paul H. Mayo |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Inservice Training Leadership and Management medicine.medical_treatment Radiography Thoracentesis Assessment and Diagnosis Spinal Puncture Asymptomatic Hospital Medicine medicine Humans Care Planning Societies Medical Ultrasonography Interventional Lumbar Vertebrae medicine.diagnostic_test business.industry Lumbar puncture Health Policy Ultrasound General Medicine medicine.disease Diaphragm (structural system) Hospital medicine Knowledge Pneumothorax Practice Guidelines as Topic Fundamentals and skills Clinical Competence Radiology medicine.symptom business |
| Zdroj: | Journal of Hospital Medicine. |
| ISSN: | 1553-5606 |
| DOI: | 10.12788/jhm.3197 |
| Popis: | Executive Summary: 1) We recommend that ultrasound should be used to guide thoracentesis to reduce the risk of complications, the most common being pneumothorax. 2) We recommend that ultrasound guidance should be used to increase the success rate of thoracentesis. 3) We recommend that ultrasound-guided thoracentesis should be performed or closely supervised by experienced operators. 4) We suggest that ultrasound guidance be used to reduce the risk of complications from thoracentesis in mechanically ventilated patients. 5) We recommend that ultrasound should be used to identify the chest wall, pleura, diaphragm, lung, and subdiaphragmatic organs throughout the respiratory cycle before selecting a needle insertion site. 6) We recommend that ultrasound should be used to detect the presence or absence of an effusion and approximate the volume of pleural fluid to guide clinical decision-making. 7) We recommend that ultrasound should be used to detect complex sonographic features, such as septations, to guide clinical decision-making regarding the timing and method of pleural drainage. 8) We suggest that ultrasound be used to measure the depth from the skin surface to the parietal pleura to help select an appropriate length needle and determine the maximum needle insertion depth. 9) We suggest that ultrasound be used to evaluate normal lung sliding pre- and postprocedure to rule out pneumothorax. 10) We suggest avoiding delay or interval change in patient position from the time of marking the needle insertion site to performing the thoracentesis. 11) We recommend against performing routine postprocedure chest radiographs in patients who have undergone thoracentesis successfully with ultrasound guidance and are asymptomatic with normal lung sliding postprocedure. 12) We recommend that novices who use ultrasound guidance for thoracentesis should receive focused training in lung and pleural ultrasonography and hands-on practice in procedural technique. 13) We suggest that novices undergo simulation-based training prior to performing ultrasound-guided thoracentesis on patients. 14) Learning curves for novices to become competent in lung ultrasound and ultrasound-guided thoracentesis are not completely understood, and we recommend that training should be tailored to the skill acquisition of the learner and the resources of the institution. |
| Databáze: | OpenAIRE |
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