Color Flow Doppler Point of Care Ultrasound to Evaluate Vessels before Infant Lumbar Puncture.
BACKGROUND
Infant lumbar punctures (LPs) are common procedures performed in the emergency department. However, 10% to 35% of these LPs are unsuccessful or grossly bloody, which can lead to increased hospitalization, increased costs, and prolonged exposure to antibiotics or antivirals. Point of care ultrasound (POCUS) may help to surmount the intrinsic causes of LP failure by providing a visual guide of the vascular structures in the needle path before a LP is performed.


METHODS
We report two cases where color flow Doppler POCUS was used to identify vascular structures around the spinal canal in infants before attempting a LP. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Color flow Doppler POCUS directly visualizes the spinal vascular structures in infants and may help guide the physician in the decision-making process of what intervertebral space and stylet placement to use for a LP.
Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York.
Brunhild M
BM
Halm
Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York.
David O
DO
Kessler
D001808:Blood Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D002555:Cerebrospinal Fluid; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D061214:Patient Safety / Q000592:standards; D019095:Point-of-Care Systems / Q000592:standards*; D013129:Spinal Puncture / Q000379:methods*; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
color flow Doppler; infant; lumbar puncture; point of care ultrasound