Sara Gottesman: Illustrating a New Way to Enhance Patient Care »

Patients with serious liver disease often build up fluid in their abdomen. This fluid can become infected, which can make the patient very sick or even kill them. A diagnostic paracentesis is a procedure where we use a small needle to sample and test the built-up abdominal fluid for bacteria and white blood cells, which helps us confirm infection and select the right antibiotic to treat the patient. 

The original diagnostic kits are large and include extra pieces for procedures other than diagnostic paracenteses, which makes it difficult for trainees still getting comfortable with the procedure. I created a simplified diagnostic paracentesis kit with only the necessary supplies along with clarified instructions to address this. The idea was to make a kit that was easy for the residents to access, fast to use and reduce any confusion or discomfort that may come with using the more complicated kit currently available to us.  

Instead of the original kit’s complicated needle and multistep catheter system, the new kit has an angiocath — a small needle with an integrated catheter. These are more commonly used to start IVs, but they are easy to direct and have a part of the device where fluid will “flash,” allowing residents to confirm they are pulling fluid from the right area. 

I’m most proud of the instructional sheet that I made to go with the kit: It’s an illustration that reminds residents how to set up for the procedure, how to perform the needle tap to retrieve fluid and how to order the appropriate labs after the sample is collected.