Recently, a colleague of mine was wanting to perform a diagnostic tap on a patient with cough, fever and a CXR suggesting a left sided pleural effusion….
I was asked to perform a bedside USS to mark out the safest place to perform the pleural aspirate.
I percussed the chest to the dullest point and then slapped the ultrasound on (left posterior chest wall, longitudinal plane, just below tip of scapula).
This is what I saw…
Needless to say the needle was re-sheathed and the procedure aborted. I am convinced that if we were going by x-ray and clinical examination alone we would have created more problems for this guy.
What made a difference….