Hey, folks, Scott Weingart here, and this is the M-Crit podcast.

Today on the podcast, another procedural episode, and the procedure we're going to be covering

today is paracentesis.

Now, we are going to briefly discuss diagnostic, but the mainstay of this conversation is going to be large volume paracetesis.

Before we get in, two quick things. First of all, Reanimate is sold out for both docs and non-docs.

I tell you this every year, no one listens, and I'm sure I'm going to get

countless emails saying, oh, I need a space. I need a space. If you still want to come,

put your name on the waiting list. We always open, I think, one or two slots inevitably

from people pulling out, but should have listened to me. It should have signed up early,

because now we are sold out in August. And then unburnable, our burnout course, now has

CME approved for it. So if that was the reason you weren't doing it, is like they won't pay for it

at my hospital unless it's CME, we have continuing medical education for both nurses and doctors

for the unburnable burnout course. If you're interested in that, unburnable, unburnable course.com.

All right, let's get into the show.

So quick stuff about diagnostic.

I think the main point you need to understand is that SBP, spontaneous bacterial parthenitis,

is a silent killer, that these patients, yeah, sure,

they may be symptomatic, but oftentimes they are not.

And so for me, if a patient has an illness and they are coming to the emergency department,

you know, so it's not a sprained ankle, it's not a, you know, musculoskeletal injury,

they have an illness, they have vague symptoms, or they have a fever, or they're just unwell. And they have ascites. Tap them. If they have ascites you could get to with a needle, tap it and send it. That's my rule because I've been burned sometimes when I'm like, ah, no, they seem fine. There's no abdominal pain. There's no fever. For me, the indication for a tap is the

presence of a CITES in a patient with illness. And if you disagree, let me know, but I think the evidence

...