Pleural aspirationPleural aspiration is a medical procedure in which a small needle or tube is inserted into the pleural space (the space between the lungs and chest wall) to drain the fluid or air that has accumulated into the chest cavity around the lungs.It is also known as pleural tap,thoracentesis or thoracocentesis.
IndicationsPleural aspiration is done normally for diagnosis purpose but it is also used therapeutically to provide relief to the patient.It is indicated in the following conditions:
* Unilateral or bilateral pleural effusion
* Primary and secondary pneumothorax
It can also be performed in cancer, congestive heart failure, pneumonia and tuberculosis if they cause pleural effusion.Occationally the drain is indicated for the introduction of certain mediations into the pleural space.
ContraindicationsThere are some conditions in which pleural aspiration should not be performed:
* Without the consent of the patient
* Coagulation disorder
* Positive end-respiratory pressure (PEEP)
* One functioning lung
Equipment'sSet up the bedside trolley before starting the procedure.The equipemnts used in the pleural aspiration are as follows:
* Sterile gloves
* Sterile drapes
* Pink prep solution (2% Chlorexidine in isopropyl alcohol)
* Local anesthetic (1% lidocaine)
* Green needle 21G and 50 ml syringe
Procedure1-Place the patient sitting upright and leaning forward on the table at an angle of 45 degree.2-Place sterile drape on the patient.
3-Clean the skin with antiseptic solution (pink prep solution)
4-Introduce local anesthetic in the skin.
5-Find the 'triangle of safety'.
6-Make a small cut on the skin and insert the needle or tube.7-Ask your patient to hold the breath.Aspirate the fluid and collect it in either a syringe or a drainage bag.
8-Remove the tube or needle and cover the skin with a dressing.
After the procedure patient may experience tenderness, pain and bruising over the area for some days.Simple painkillers such as tylenol or panadol can be taken to relieve the pain.Along with them, following complications may occur:
* Infection* Hemorrhage
* Pulmonary edema* Subcutaneous hematoma
* Injury to heart, liver or spleen
Patients educations* Ask your patient not to eat or drink 4 hours before the procedure.* Tell him to Stop taking aspirin or any other blood thinners one week before the procedure.
* Explain the patient about the procedure.
* Ask the patient to sit still and hold his breath between the procedure.
* Tell your patient that it is a short procedure and will only take 20-30 minutes.* Tell your patient that he can ask for painkillers if he experience any pain.
* Tell him to arrange a drive to his home after the procedure.