CORE IM podcast: Mind The Gap on Admission Paracentesis

Core IM | Internal Medicine Podcast

Core IM Team

Mental Health, Education, Health & Fitness, Medicine

4.8 • 1K Ratings

🗓️ 1 November 2017

⏱️ 10 minutes

🔗️ Recording | iTunes | RSS

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Summary

You have always been told to do a diagnostic paracentesis on admission in cirrhotics with ascites, but why? Can you just get away with clinical judgement to rule out SBP? Is faculty judgement any better? And if you’re going to do a paracentesis on admission, do you need to do it right away? Go deeper with Dr. Steve Liu and Dr. Janine Knudsen! Click the link for the full show notes: https://www.coreimpodcast.com/2017/11/01/mind-the-gap-admission-paracentesis/ (https://www.coreimpodcast.com/2017/11/01/mind-the-gap-admission-paracentesis/) Time Stamps * What do guidelines say about diagnostic paracentesis in cirrhotics with ascites? (1:51) * Can we just use clinical judgement to decide if paracentesis is warranted? (3:13) * Do attendings have better clinical judgement than residents to rule out SBP? * Does timing of paracentesis on admission matter for mortality? (6:33) Find the best disability insurance for you: https://www.patternlife.com/disability-insurance?campid=497840 Advertising Inquiries: https://redcircle.com/brands Privacy & Opt-Out: https://redcircle.com/privacy

Transcript

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0:00.0	Hi, I'm Janine Knutson.
0:05.0	And I'm Steve Lou.
0:06.0	Welcome to our new podcast, Mind the Gap.
0:09.0	This is a show where we explore why we do the things we do.
0:12.0	Things like repleting lights to four, or putting that blood gas on ice.
0:16.0	Hopefully we can help confirm, or do away with,
0:19.0	all these habits that we take for granted day to day.
0:21.0	The general plan is here, we're going to explore a theme.
0:24.1	In this episode we're going to be talking about the guideline recommendation to
0:27.4	perform a diagnostic parastanthesis for serotics on admission. Our goal here is to
0:32.0	explore number one what do the guidelines say and why?
0:35.3	And number two, can you just use your clinical judgment to decide if Parisanthesis is warranted?
0:39.9	And finally, number three, if you're going to do a a tap do you need to do it right away
0:43.8	Right so some of this is just going to be basic management skills and
0:47.2	while you probably did learn all of this on rounds sometimes the wise and
0:52.4	the wherefores are kind of passed on like folklore rather than citation.
0:57.0	Exactly, but the point is that what we often know what to do on those busy holidays, there's no time to explore why. So as an FYI feel free to follow
1:04.6	along with us on the trial link below. This is our chance to dig a little deeper.
1:08.8	Yeah like inception. No not at all like it's exactly like inception. No, not at all like... It's exactly like inception.
1:14.0	We must go deeper into the dream.
1:17.0	Oh, see. You're listening to Mind the Gap. I'm Janine Knutson.
1:28.0	And I'm Steve Louth. Today we're talking about abdominal paracetesis.
	...

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