Vascular Ultrasonography: A Novel Method to Reduce Paracentesis Related Major Bleeding.

Paracentesis is a core competency for hospitalists. Using ultrasound for fluid localization is standard practice and involves a low-frequency probe. Experts recommend a "2-probe technique, " which incorporates a high-frequency ultrasound probe in addition to the low-frequency probe to identify blood vessels within the intended needle path.

Thoracentesis outcomes: a 12-year experience.

Background: Despite a lack of evidence in the literature, several assumptions exist about the safety of thoracentesis in clinical guidelines and practice patterns. We aimed to evaluate specific demographic and clinical factors that have been commonly associated with complications such as iatrogenic pneumothorax, re-expansion pulmonary oedema (REPE) and bleeding.

Methods: We performed a cohort study of inpatients who underwent thoracenteses at Cedars-Sinai Medical Center (CSMC) from August 2001 to October 2013.

Portable ultrasound: the next generation arrives.

PURPOSE: A new category of handheld devices has recently emerged that are even smaller than current portable models, with their main advantages being increased portability and affordability relative to their counterparts. However, these new devices have not yet been thoroughly evaluated in the clinical setting. METHODS: A prospective, non-blinded, three-phase study was designed to evaluate a handheld ultrasound device as compared to a common compact ultrasound machine for the performance of paracenteses and thoracenteses on human patients.

The use of tissue models for vascular access training. Phase I of the procedural patient safety initiative.

Introduction: Following the Institute of Medicine report "To Err is Human," the Agency for Healthcare Research and Quality identified proper central venous catheter (CVC) insertion techniques and wide sterile barriers (WSB) as 2 major quality indicators for patient safety. However, no standard currently exists to teach proper procedural techniques to physicians.

Aim: To determine whether our nonhuman tissue model is an effective tool for teaching physicians proper wide sterile barrier technique, ultrasound guidance for CVC placement, and sharps safety.

Percutaneous dilatational tracheostomy for emergent airway access.

The study objective of this article was to evaluate percutaneous dilatational tracheostomy (PDT) for emergent airway access. This is a case series of 9 patients who presented over a 58-month period. All patients were in severe respiratory difficulty where intubation by conventional means was unsuccessful.