Ultrasound mind and body
Safety is key before you begin any ultrasound-guided procedure.
Bedside procedures using ultrasound — such as paracentesis, thoracentesis, lumbar punctures and central lines — were once considered the purview of trainees and attending physicians. And while they may have mostly moved to radiology and other departments, hospitalists are often required to perform them.
Manpreet Malik, MD, SFHM, said it is more important than ever for hospitalists to learn the basics of ultrasound-guided procedural safety.
“Evaluating each patient for performing the procedure safely based on clinical scenarios, lab parameters and ultrasound imaging are important steps before performing the procedure,” he said. “Hospitalists are the critical thinkers and decision makers before any of these procedures are performed.”
Dr. Malik, who serves as program director for the Emory Transitional Year Program, assistant division director for faculty development and associate professor of medicine at the Emory University School of Medicine in Atlanta, Georgia, will be leading a discussion of those safety procedures in Sunday’s session, “To Stick or Not To Stick: A Primer on Ultrasound Guided Procedural Safety.”
While many technical aspects of these procedures have remained the same, Dr. Malik said that ultrasound has enhanced safety and the literature has advanced significantly from a laboratory values and medication standpoint.
“Some of us probably remember training in the days of fresh frozen plasma (FFP) being given to bring (the) internal normalized ratio (INR) down to a certain level before a bedside paracentesis would be performed. Those days are long gone,” he said. “In addition, the availability of ultrasound- and POCUS-trained hospitalists has completely changed our pre-procedure evaluation for each patient.”
Dr. Malik said he plans to use real-life cases to illustrate the proper safety protocols for ultrasound guided procedures.
“We are going to discuss the use of POCUS for each procedure, emphasize technical tips and tricks and then discuss some pitfalls in our evaluations,” he said. “It’s an early session, so grab a cup of coffee. We’re going to go through a lot.”
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