A paracentesis procedure is often performed in the Emergency Department to rule a patient out for spontaneous bacterial peritonitis (SBP).
- Do you check coagulation studies before performing the procedure?
- How comfortable do you feel that the patient has SBP with an ascites WBC > 500 cells/microliter or ascites PMN > 250 cells/microliter?
This installment of the Paucis Verbis (In a Few Words) e-card series provides an evidence-based review of the literature on topics related to the paracentesis procedure. Especially helpful is the pooled data of likelihood ratios. Like most everything in medicine, a lab test should be used in conjunction with your pretest probability in clinical decision making, and LR’s help with with this.
PV Card: Ascites and Paracentesis
Adapted from  Go to ALiEM (PV) Cards for more resources.
- Wilkerson RG, Sinert R. The Use of Paracentesis in the Assessment of the Patient With Ascites. Annals of Emergency Medicine. 2009;54(3):465-468. doi: 10.1016/j.annemergmed.2008.09.005