September 17, 2021 It's What's Inside Us

Category: Procedures

Ultrasound-Guided Lumbar Puncture

A 68-year old obese female with a past medical history of osteoarthritis, diabetes, and cervical spinal fusion presents to the Emergency Department (ED) complaining of generalized weakness for the last week. In addition, she reports that she had cold symptoms approximately one week before the onset of her weakness. Upon further questioning, the patient also reports numbness and tingling of her bilateral lower extremities. The review of systems is otherwise negative.

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TLC: Triple Lumen Complications

Placing central venous cathethers, whether under ultrasound guidance or based off of your landmarks can be difficult and still prone to many complications. With the increased use and now standard of care for placing central lines with ultrasound guidance you would think we are immune to the “catastrophic” complication of an inadvertent arterial cannulation. But does ultrasound make us infalliable? Are there other methods that we can use to confirm venous placement of these large catheters?

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