SonoKids PROC LP

BACKGROUND: Lumbar puncture (LP) is one of the essential diagnostic tools in pediatric emergency services. Recently, ultrasound-assisted LP was reported to be beneficial in the emergency service by facilitating the procedure and improving the successful procedure rates. In addition, this method may be effective in reducing patient and parent anxiety due to the LP procedure. OBJECTIVES: The aim of this study was to investigate the effect of ultrasound-assisted LP on the outcomes of puncture procedures and traumatic LP...

The widespread availability of ultrasound (US) technology has increased its use for point of care applications in many health care settings. Focused (point of care) US is defined as the act of bringing US evaluation to the bedside for real-time performance. These images are collected immediately by the practitioner, allowing for direct integration into the physician's medical decision-making process. The real-time bedside diagnostic ability of US becomes a key tool for the management of patients. The purpose of this review is to (1) provide a general description of the use of focused US for bedside procedures; (2) specify the indications and common techniques used in bedside US procedures; and (3) describe the techniques used for each bedside intervention...

OBJECTIVES: Lumbar punctures (LPs) are typically performed using anatomical surface landmarks. However, as body mass index increases, identifying surface landmarks becomes more difficult. Ultrasound has been proposed as a tool for identifying these landmarks prior to LP. This study evaluates the effectiveness of a brief training program in ultrasound identification of anatomical landmarks in a simulated obese model prior to completing an LP. METHODS: Pediatric emergency medicine physicians completed a pretest questionnaire on ultrasound familiarity prior to an educational session...

BACKGROUND: Lumbar punctures are commonly performed in the pediatric emergency department. There is no standard, recommended, optimal position for children who are undergoing the procedure. OBJECTIVE: To determine a position for lumbar punctures where the interspinous space is maximized, as measured by bedside ultrasound. METHODS: A prospective convenience sample of children under age 12 was performed. Using a portable ultrasound device, the L3-L4 or L4-L5 interspinous space was measured with the subject in 5 different positions...

BACKGROUND: Ultrasound-assisted lumbar puncture in the pediatric emergency medicine setting has not been well established, but ultrasound could serve as a valuable tool in this setting. OBJECTIVE: To assess whether ultrasound increases provider confidence in identifying an insertion point for lumbar puncture. METHODS: A feasibility study was conducted using a convenience sample of pediatric emergency patients requiring lumbar puncture. Provider confidence in selecting a needle insertion site for lumbar puncture using ultrasound assistance was compared to provider confidence using traditional landmarks alone...