Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 
  • Users Online: 572
  • Home
  • Print this page
  • Email this page
Year : 2019  |  Volume : 5  |  Issue : 3  |  Page : 165-170

A comparison of ultrasound-guided and palpation-guided identification of lumbar puncture needle entry site in patients as body mass index increases

1 Department of Emergency Medicine, Methodist Charlton Medical Center, Dallas, TX, USA
2 Department of Anesthesia, Medical College of Georgia, Augusta University, Augusta, GA, USA
3 Department of Emergency Medicine, St. Luke's University Hospital, Bethlehem, PA, USA

Correspondence Address:
Dr. Donald Jeanmonod
St. Luke's University Hospital, 801 Ostrum Street, Bethlehem, PA 18015
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/IJAM.IJAM_45_18

Rights and Permissions

Background: This was a prospective, crossover study examining the ability of emergency medicine (EM) residents to identify lumbar puncture (LP) needle entry site by palpation and ultrasound in individuals with varying body mass indexes (BMIs). Materials and Methods: Following a didactic session on the use of ultrasound to identify landmarks for LP needle entry, EM resident physicians were asked to identify LP needle entry sites using ultrasound on several volunteers of varying BMIs (normal [BMI, 18.5–24.9], overweight [BMI, 25.0–29.9], and obese [BMI, 30–39.9]). Measurements of their deviation from an entry point determined by a faculty member with expertise in ultrasound were recorded. Residents were then asked to determine LP needle entry sites using palpation and again the deviation was recorded. Results: Using ultrasound, the transverse and longitudinal deviations from a gold standard were 7.8 mm (standard deviation [SD]: 6.5 and confidence interval [CI]: 1.9) and 7.1 mm (SD: 5.2 and CI: 1.5), respectively, whereas using palpation, the transverse and longitudinal deviations from our gold standard were 4.4 mm (SD: 3.4 and CI: 0.99) and 8.2 mm (SD: 6.6 and CI: 1.9), respectively. Conclusion: There was no difference in the residents' ability to identify LP needle entry sites on volunteers of various BMIs when comparing the use of ultrasound to standard palpation. The following core competencies are addressed in this article: Patient care and procedural skills, Medical knowledge.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded81    
    Comments [Add]    

Recommend this journal