Title: Ultrasound-Assisted Lumbar Punctures<br/>Author: WanTsu Wendy Chang<br/><a href='http://umem.org/profiles/faculty/1322/'>[Click to email author]</a><hr/><ul style="caret-color: rgb(0, 0, 0); color: rgb(0, 0, 0); font-family: -webkit-standard;">
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                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Lumbar punctures (LPs) are a common ED procedure with variable reported success rates.</span></span></li>
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                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">A recent systematic review and meta-analysis looked at 12 studies comprising 957 adult and pediatric patients comparing pre-procedural ultrasound-assisted LPs with traditional landmark-based technique.</span></span>
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                                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Some studies utilized ultrasound-assistance in all LPs, others selected patients who were anticipated to be difficult LPs.</span></span></li>
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                                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">No studies assessed dynamic ultrasound-guided LPs.</span></span></li>
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                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Overall, <u>ultrasound-assisted LP was 90.0% successful</u> compared with <u>landmark-based LP that was 81.4% successful</u> (OR 2.22, 95% CI = 1.03 - 4.77).</span></span></li>
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                <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;">Ultrasound-assisted LP was also associated with reduced rate of traumatic LPs, shorter time to successful LP, and reduced patient pain scores.</span></span></li>
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        <span style="font-size:14px;"><span style="font-family:arial,helvetica,sans-serif;"><strong><u>Bottom Line</u>: </strong>Consider using pre-procedural ultrasound-assistance for all lumbar punctures.</span></span></p>
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        <span style="caret-color: rgb(0, 0, 0); color: rgb(0, 0, 0); font-family: arial, helvetica, sans-serif; font-size: 14px;">Gottlieb M, Holladay D, Peksa GD. Ultrasound-assisted lumbar punctures: a systematic review and meta-analysis. <em>Acad Emerg Med.</em> 2018 Aug 21. [Epub ahead of print]</span></p>
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