An iatrogenic pneumothorax caused during a thoracentesis procedure could be reasonably prevented through the application of evidence-based guidelines regarding the use of ultrasound guidance when performing a thoracentesis. The American College of Emergency Physicians in their criteria compendium for emergency ultrasound imaging, states that procedural ultrasound to evaluate for and/or drain with ultrasound guidance or localization pleural effusion (thoracentesis) is a standard practice.

Paracentesis, a common procedure used in the management of ascites in patients with cirrhosis, can cause hemorrhagic complications during the procedure, due to needle puncture of local vessels.

In a prospective, randomized clinical trial, emergency medicine physicians successfully performed paracentesis in 95% of patients under ultrasound guidance.1 While only 61% of patients were successfully managed using the traditional technique.

Adding these two conditions to the HAC Reduction Program would lead to higher quality, better patient care.
 
DOTmed News: What else is happening to hospitals?

JR: There are the CY 2015 Medicare Hospital Outpatient Prospective Payment System and the Medicare Physician Fee Schedule Final Rules that were released on October 31, 2014. Both rules have changes regarding increased emphasis on quality reporting and the hospital outpatient payment rule continues to expand packaging for procedures with costs less than $100 that are performed on the same day as another procedure in a hospital emergency room or a hospital outpatient clinic.


Jill Rathbun can be reached at jill_rathbun@galileogrp.com

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