Background: Lumbar punctures (LPs) are common among hospitalized patients and many institutions have implemented a hospital medicine procedure services (HMPS) to perform these routine bedside procedures. Most clinicians learn to perform this procedure using the midline (ML), landmark-guided approach which involves palpation of the lumbar spine but this technique is associated with failure rates as [...]

Background: Post-medical procedure complications are a critical area of healthcare, often resulting from infections, device failures, or unforeseen physiological responses. These events, while rare, can have significant impacts on patient safety and outcomes, even leading to mortality. Robust preventive measures and post-procedure monitoring are thus necessitated. This study analyzed trends and disparities in mortality rates [...]

Background: Post-surgical procedure-related mortality is a critical area of healthcare, frequently linked to complications such as excessive bleeding, sepsis, organ failure or adverse reactions to anesthesia. Given the devastating nature of these complications and their effects on patient safety, the importance of robust surgical protocols and post-op monitoring is highlighted. This study analyzed trends and [...]

Background: Diagnosis of complications is important for patient care, diagnostic quality, and safety. Paracentesis is a common procedure among hospitalized patients. The use of ultrasound decreases complications and improves safety. We aimed to characterize the complication rate observed among paracenteses performed by a hospital medicine bedside procedures service (MPS) before and after a transition to [...]

Background: Kidney Dialysis is a vital treatment for patients with end-stage renal disease. But lately, there has been an alarming increase in deaths related to this procedure. This study analyzed mortality trends and disparities among adults aged 15 and older from 1999 to 2020. Methods: The study examined post- kidney dialysis complications-related mortality in the [...]

Background: Mounting evidence supports the use of point-of-care ultrasound (POCUS) in medicine and pediatrics to improve outcomes, maximize patient safety, and increase patient satisfaction and success of procedures.The literature describes the utility of POCUS in several areas of pediatric care (the emergency department, pediatric and neonatal intensive care unit, and post-acute care setting), however, we [...]

Background: Among bedside procedures, factors such as body mass index (BMI), prior spinal procedures, and complex spinal anatomy are known to affect the success of lumbar punctures (LP) [2, 3]. However, the phenomenon of a “dry tap,” where cerebrospinal fluid (CSF) cannot be obtained despite the needle tip being correctly positioned in the thecal sac, [...]

Background: Many hospitalist programs have established a bedside procedure team to encourage timeliness of necessary bedside procedures, reduce diagnostic delays, and decrease length of stay. We assessed the impact of a bedside procedure team on the timeliness of the procedure and length of stay (LOS). Methods: A hospitalist-run On-call Procedure Team (OPT) was launched in [...]

Background: Routine transfusion of platelets and Fresh Frozen Plasma (FFP) prior to paracentesis is among the “things we do for no reason”, as recommended against by the American Association of Liver Disease and American Gastroenterology Association in patients with platelets over 20,000. We hypothesize that a Medicine Procedure Service (MPS), which has adopted this recommendation [...]

Background: Medicine procedure services (MPSs) have been shown to increase procedure volume, procedure completion rate, adherence to best practice safety measures, resident involvement, and resident satisfaction, and decrease length of stay within Internal Medicine (IM) [Ref 1-4]. However, the frequency with which MPSs rely on other services, particularly Interventional Radiology (IR), for assistance to complete [...]