Paucis Verbis card: Ascites assessment with paracentesis
Posted Jun 25 2010 12:00am
A paracentesis procedure is often performed in the Emergency Department to rule a patient out for spontaneous bacterial peritonitis (SBP).
Do you check coagulation studies before performing the procedure?
How comfortable do you feel that the patient has SBP with an ascites WBC > 500 cells/microliter or ascites PMN > 250 cells/microliter?
This installment of the Paucis Verbis (In a Few Words) e-card series provides an evidence-based review of the literature on topics related to the paracentesis procedure. Especially helpful is the pooled data of likelihood ratios. Like most everything in medicine, a lab test should be used in conjunction with your pretest probability in clinical decision making, and LR's help with with this.
Feel free to download this card and print on a 4'' x 6'' index card.
Reference Wilkerson, R., & Sinert, R. (2009). The Use of Paracentesis in the Assessment of the Patient With Ascites. Annals of Emergency Medicine, 54 (3), 465-468 DOI: 10.1016/j.annemergmed.2008.09.005