SHM Converge Scientific Abstract ePoster Gallery-Standardization of Ultrasound for Lumbar Puncture Using a Paramedian Approach

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This study evaluated whether in-service training on an ultrasound-assisted paramedian lumbar puncture (LP) technique improved procedure success for the University of Minnesota Internal Medicine Procedure Service. Between October 6, 2017 and May 5, 2022, 20 faculty members attempted 467 LPs.<br /><br />The main finding was a significant improvement in bedside LP success after the intervention. Success rates increased from 72.8% before training to 87.5% after training, with a highly significant p-value of 0.0001. The training focused on using ultrasound to identify spinal landmarks and guide a paramedian approach, which can help clinicians access the lumbar space more effectively.<br /><br />The authors conclude that teaching internal medicine proceduralists this ultrasound-assisted technique was feasible and widely adopted. The results suggest that, in hospitalized adults, ultrasound-assisted paramedian LP may lead to better procedural success than prior practice. This adds to earlier evidence supporting ultrasound guidance for lumbar puncture and is notable because it specifically examines a paramedian approach rather than standard landmark-based methods.<br /><br />However, the study has limitations. The initial analysis accounted for differences among proceduralists, but not yet for patient-specific or procedure-specific factors that may have influenced success. The authors note that further analysis is underway, including examination of number of attempts, success by inter-spinal space, and traumatic LP rates.<br /><br />Overall, the study supports in-service ultrasound training as a practical way to improve LP performance and suggests that this technique could benefit bedside procedural practice.

Asset Subtitle

Jacob J. Wagner

Meta Tag

Author List Jacob J. Wagner, Matthew Yocum, Zachary Kaltenborn

Category Research

Concept In-service Training

Concept Ultrasound-assisted paramedian lumbar puncture

Concept Lumbar Puncture

Concept Competency

Concept Ultrasound

Distinguished Non-Finalist

Presenter Organization University of Minnesota

Presenting Author Jacob J. Wagner

Track Outcomes Research

Keywords

ultrasound-assisted lumbar puncture

paramedian approach

in-service training

procedure success

bedside lumbar puncture

internal medicine proceduralists

spinal landmarks

ultrasound guidance

hospitalized adults

procedure service

In-service Training

Ultrasound-assisted paramedian lumbar puncture

Lumbar Puncture

Competency

Ultrasound