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Procedural Ultrasound In Pediatric Patients: Techniques And Tips For Accuracy And Safety

June 2016

Abstract

Point-of-care ultrasound is becoming more prevalent in pediatric emergency departments as a critical adjunct to both diagnosis and procedure guidance. It is cost-effective, safe for unstable patients, and easily repeatable as a patient's clinical status changes. Point-of-care ultrasound does not expose the patient to ionizing radiation and may obviate the need for procedural sedation. Because the use of point-of-care ultrasound in pediatric emergency medicine is relatively new, the body of literature evaluating its utility is small, but growing. Data from adult emergency medicine, radiology, critical care, and anesthesia evaluating the utility of ultrasound guidance must be extrapolated to pediatric emergency medicine. This issue will review the adult literature and the available pediatric literature comparing ultrasound guidance to more traditional approaches. Methods for using ultrasound guidance to perform various procedures, and the pitfalls associated with each procedure, will also be described.

Keywords: point-of-care ultrasound, POCUS, bedside ultrasound, procedural ultrasound, emergency ultrasound, pediatric, peripheral venous access, central venous access, lumbar puncture, bladder catheterization, foreign body

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Abstract

Point-of-care ultrasound is becoming more prevalent in pediatric emergency departments as a critical adjunct to both diagnosis and procedure guidance. It is cost-effective, safe for unstable patients, and easily repeatable as a patient's clinical status changes. Point-of-care ultrasound does not expose the patient to ionizing radiation and may obviate the need for procedural sedation. Because the use of point-of-care ultrasound in pediatric emergency medicine is relatively new, the body of literature evaluating its utility is small, but growing. Data from adult emergency medicine, radiology, critical care, and anesthesia evaluating the utility of ultrasound guidance must be extrapolated to pediatric emergency medicine. This issue will review the adult literature and the available pediatric literature comparing ultrasound guidance to more traditional approaches. Methods for using ultrasound guidance to perform various procedures, and the pitfalls associated with each procedure, will also be described.

Keywords: point-of-care ultrasound, POCUS, bedside ultrasound, procedural ultrasound, emergency ultrasound, pediatric, peripheral venous access, central venous access, lumbar puncture, bladder catheterization, foreign body

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