Background: The American Board of Internal Medicine suggests residents participate in a minimum of five abdominal paracentesis (AP), central venous catheter (CVC) placements, and lumbar punctures to ensure “adequate knowledge and understanding” of procedures performed by practicing internists. Competency in these procedures is poorly defined and difficult to assess. To address the need for well-supervised, [...]

Background: Small-bore pulmonary drains (PD) have been proven effective at replacing the previous large-bore chest tubes for resolution of pneumothorax (PTX), and management of complicated (CPEs) and recurrent pleural effusions (RPEs). The placement of these drains has traditionally been performed by Surgeons, Intensivists/Pulmonologists, and Interventional Radiologists. Our institution (large academic center) sought to determine whether [...]

Background: Internal medicine and hospital medicine providers are under pressure to move patients quickly through the hospital and decrease length of stay. Providers spend most of their clinical time seeing patients, documenting or coordinating care and have minimal time to disrupt workflow to perform common bedside procedures such as paracentesis, lumbar punctures, central lines, arthrocentesis [...]

Background: Over 1 million patients are hospitalized in the United States yearly for pneumonia, of which 40% develop parapneumonic effusion. Left untreated, these effusions can progress to complex effusions requiring more invasive treatment, including tube thoracostomy and surgical decortication, increasing hospital length of stay and overall morbidity. In patients with complex parapneumonic effusion, intrapleural lytic [...]