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    Default Pull out the Ultrasound - Youre going to need it...

    Recently, the ED sent over a patient for a LP that they felt it would be too challenging to get a sample - so we got it.

    In walks a young lady about 399 lbs about 62 inches. My partner and myself just give each other the "look." After losing at rocks, paper, & sissors, I do the required H&P, consent, ect.

    In our block room, we also keep our US - and after determining there are ZERO external landmarks to go with - I pull old betsy out, chose the 5-2 curved array (30 cm depth), had the patient in the lateral decubitus postion, and quickly found the lumbar spinous processes, marked them on the skin, and was able to accomplish the LP with only 1 redirect.

    Below is an article from the neuraxiom site that talks about the specifics.

    I keep thinking about using this with difficult OB patients. I havent yet...but there will come a day...

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