probe prevents probe…

Recently, a colleague of mine was wanting to perform a diagnostic tap on a patient with cough, fever and a CXR suggesting a left sided pleural effusion….

I was asked to perform a bedside USS to mark out the safest place to perform the pleural aspirate.

I percussed the chest to the dullest point and then slapped the ultrasound on (left posterior chest wall, longitudinal plane, just below tip of scapula).
This is what I saw…

Needless to say the needle was re-sheathed and the procedure aborted. I am convinced that if we were going by x-ray and clinical examination alone we would have created more problems for this guy.

What made a difference….

  1. Turner JP, Dankoff J. Thoracic ultrasoundEmerg Med Clin North Am. 2012 May;30(2):451-73.
  2. Ultrasound Podcast Episode 31 (Pneumothorax & Pleural Effusion) & Episode 32 (Pneumonia & ARDS)
  3. Sonocloud