Radiology Procedures: Paracentesis (Fielding The Consult For A Paracentesis)

OVERVIEW

Often times other services may consult radiology directly for a requested paracentesis. This is an excellent opportunity to be able to speak directly with the provider(s) who is ordering the paracentesis and make sure you are able to collect pertinent information quickly.For more general information on how to field radiology procedure consults please refer to this page.

Radiologists have the opportunity to not only be proceduralists but consultants as well. It is important to be able to speak with the physicians who are ordering radiology procedures and help them whenever possible (image source).
WHY DOES THIS PATIENT NEED RADIOLOGY TO PERFORM THE PARACENTESIS:

It is important to appreciate that interventional radiologists are not the only providers that can perform a paracentesis. While often times interventional radiology departments have the appropriate infrastructure to perform paracentesis in the outpatient setting, especially in the case of inpatients other services (such as primary medicine services or special medicine procedural teams) have the ability to perform paracentesis on the floor/bedside.

If interventional radiology is being consulted to perform a paracentesis it is important to establish why this is. Often times it is possible that other teams may not feel comfortable performing the procedure given the anatomy of the patient (such as in an instant where the pocket of ascites is very small and difficult to sample safely).

WHAT ANALYSIS SHOULD THE SAMPLED FLUID BE SENT FOR?

It is very important to make sure as the proceduralist that you understand if the the sampled fluid will be sent for any type of analysis (i.e. is this a diagnostic paracentesis?).

When speaking with the team ordering the paracentesis it is critical to make sure you understand all the diagnostic tests they would like to run on the sampled fluid (as well as making sure they order these tests prior to the procedure if appropriate in your care setting).

WHY DOES THIS PATIENT NEED THIS PROCEDURE URGENTLY (IF URGENT INPATIENT REQUEST)

It is not uncommon for patients to have requests for paracentesis to be placed urgently in the inpatient setting. Often times it is the role of the interventional radiologist to triage their cases and understand why a patient may need to have a paracentesis more urgently (vs a patient who may be scheduled later on in an outpatient setting).

 

Page Updated: 04.14.2019