• Am J Emerg Med · Jul 2024

    Case Reports

    Ultrasound-guided paramedian approach: A novel technique for lumbar puncture in the Emergency Department.

    • Michael Gottlieb, Katherine Kravchuk, and James R O'Brien.
    • Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, United States of America. Electronic address: michaelgottliebmd@gmail.com.
    • Am J Emerg Med. 2024 Jul 1; 81: 124126124-126.

    AbstractLumbar puncture is performed to evaluate for multiple neurologic conditions, including meningitis and subarachnoid hemorrhage. However, success rates with the landmark-based technique are limited. Ultrasound is most commonly used for pre-marking without dynamic guidance, which presents several limitations, including absence of real-time guidance and lack of reliability if any patient movement occurs after skin marking. We describe a novel, ultrasound-guided paramedian approach which was successfully performed in the Emergency Department setting for lumbar puncture. Physicians should consider this technique as an alternate model using real-time guidance to reduce needle passes in those with difficult anatomy.Copyright © 2024 Elsevier Inc. All rights reserved.

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