• Lumbar punctures (LPs) are a common ED procedure with variable reported success rates.
• 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.
  • Some studies utilized ultrasound-assistance in all LPs, others selected patients who were anticipated to be difficult LPs.
  • No studies assessed dynamic ultrasound-guided LPs.
• Overall, ultrasound-assisted LP was 90.0% successful compared with landmark-based LP that was 81.4% successful (OR 2.22, 95% CI = 1.03 - 4.77).
• Ultrasound-assisted LP was also associated with reduced rate of traumatic LPs, shorter time to successful LP, and reduced patient pain scores.

Bottom Line: Consider using pre-procedural ultrasound-assistance for all lumbar punctures.

References

Gottlieb M, Holladay D, Peksa GD. Ultrasound-assisted lumbar punctures: a systematic review and meta-analysis. Acad Emerg Med. 2018 Aug 21. [Epub ahead of print]

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