Color Flow Doppler Point of Care Ultrasound to Evaluate Vessels before Infant Lumbar Puncture

Brunhild M Halm; David O Kessler

doi:10.1016/j.jemermed.2016.06.050

Color Flow Doppler Point of Care Ultrasound to Evaluate Vessels before Infant Lumbar Puncture

J Emerg Med. 2017 Jan;52(1):70-73. doi: 10.1016/j.jemermed.2016.06.050. Epub 2016 Nov 4.

Authors

Brunhild M Halm¹, David O Kessler¹

Affiliation

¹ Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, New York.

PMID: 27823894
DOI: 10.1016/j.jemermed.2016.06.050

Abstract

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.

Case report: 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.

Keywords: color flow Doppler; infant; lumbar puncture; point of care ultrasound.

MeSH terms

Blood Vessels / diagnostic imaging
Blood Vessels / pathology*
Cerebrospinal Fluid
Female
Humans
Infant
Male
Patient Safety / standards
Point-of-Care Systems / standards*
Spinal Puncture / methods*
Ultrasonography, Doppler, Color / methods*