| ID | 418 |
|---|---|
| Name | PLEURAL TAP |
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| Management | Purpose: To remove pleural fluid for diagnosis or treatment. Position of patienr- 1. Erect sitting position, leaning forwards with arms resting on bed lable or pillows. 2. Burping portion for infants. Site for puncture-Depends on.location of pleural fluid. Usual site is at the base of the thorax in the posterior axillary line. If fluid is loculated elsewhere a site is selected over the area this is determined by x-ray and physical examination. Technique: Sterile procedure throughout. 1. Prepare area as usual. 2. Infiltrate skin and down to pleura with LA. 3. A small nick is made through the skin at the puncture site with a scalpel. 4. A 18 gauge needle is attached to the front arm of the 3 way stopcock, the rubber tubing to the side arm and a 10ml or 20ml syringe to the hub. 5. The needle is inserted in the interspace through the nick incision just above the margin of the rib. (The intercostal vessels are located immediately inferior to each rib). 6. The needle is advanced a few mm until the pleura is penetrated. This is indicated by a sudden lack of resistance. Aspirate with the syringe to ensure that the needle has reached the fluid. 7. Once the desired depth of penetration is reached, a hemostat is clamped across the needle barrel at the skin surface to fix its position and prevent inadvertent advancement of needle. 8. Fluid is aspirated into the syringe & by positionig the stop-cock, is then ejec ted through the rubber tube into the desired basin or test tube for analysis. |
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