Background: Paracentesis is a common procedure for patients with decompensated cirrhosis. In patients with cirrhosis and superimposed renal impairment, clinicians may hesitate to perform a large volume paracentesis, given concerns of intraabdominal fluid shifts resulting in further renal dysfunction. In this study, we aimed to answer whether greater ascites fluid removal was associated with 48-hour [...]

Background: While many physicians graduate from residency with competency to perform bedside procedures such as lumbar punctures (LPs) and paracentesis, the skillset often wanes after years in practice. Though a dedicated procedure service with full-time equivalent support may be a solution in settings where hospitalists need to perform numerous procedures per day, at our large [...]

Background: Hospital Medicine (HM) based procedure services have demonstrated improved outcomes for patients by reducing time to procedure, improving throughput, and decreasing length of stay. Notable barriers to service implementation and sustainability include staffing shortages, training, and payment models. Provision of bedside procedural care in the community teaching hospital setting may facilitate access to other [...]

Case Presentation: A 64-year-old female with decompensated alcoholic liver cirrhosis was admitted to the hospital for lower abdominal pain. The initial paracentesis polymorphonuclear (PMN) leukocyte count was 149 cells/mm3, but the patient was found to have E. coli urinary tract infection. During the course of her treatment, the patient developed pancreatitis and her hepatic encephalopathy [...]