6 Thoracentesis PPTserjqwjrioq2eioqouqwo2io.pptx

6 Thoracentesis PPTserjqwjrioq2eioqouqwo2io.pptx

• 2.
  o Thoracentesis isa percutaneous procedure during which a needle is inserted into the pleural space and pleural fluid is removed either through the needle or a catheter. o ‘’Pleural tap’’ OR ‘’pleural fluid aspiration’’
• 3.
   Diagnostic • Pleuraleffusion • Hemopneumothorax • Empyema  Therapeutic • Large peural effusion
• 4.
     Coagulation disorder Active skininfection Atelectasis     Only one functioning lung Emphysema Severe cough or hiccups
• 5.
   Explain thepurpose, risks/benefits, and steps of the procedure and obtain consent from the patient or appropriate legal design. R: An explanation helps orient the patient to the procedure assist in coping and provide an opportunity to ask question and verbalise anxiety
• 6.
  Do Diagnostic Testssuch as   Chest X- ray Ultrasound  Check platelet count and/or presence of coagulopathy
• 7.
   Dressing set Abraham’s needle  Connecting tubing  Syringe Needles (18 and 23 gauge)  Sterile Glove  Mask  Povidone / Alcohol  Local anaesthetic  Formalin bottle  Urine bottle x2  C+S bottle  3-way stopcock
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• 9.
   Place patientupright position Ensures that the diaphragm is more dependent and facilitates the removal of fluid. The lateral recumbent position if the patient is unable to sit upright. BEFO RE THE PROCEDURE
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• 14.
   Explain thathe/she will receive a local anesthetic to minimize pain during the procedure.  Clean patient skin with antiseptic R: 21
• 15.
   Observe patientrespiration rate and breathing pattern. R: to provide base line data to estimate patient tolerance of procedure  Assess patient vital sign such as B/P, pulse R: To prevent any complication such as hypovolemic shock during procedure.
• 16.
   Observe patientlevel of consciousness and give emotional support R: To reduce patient anxiety  Monitor saturation  R: To prevent hypoxia Drain max 1.5 L in one sitting R: avoid re-expansion pulmonary edema 25
• 17.
   Obtain achest x-ray to evaluate the fluid level. R: To compare the conditions of the lungs before and after the procedure.  For specimen handling, fill the tubes with the required amount of pleural fluid R : To prevent over intake of the fluid to the specimen bottle.  correct labelling of specimen bottle then send to the lab R: To prevent incorrect results to the patient.
• 18.
   Document theprocedure, patient’s response, characteristics of fluid and amount, and patient response to follow-up. R: To develop further treatment to the patient.  Provide post-procedural analgesics as needed. R: To prevent patient from pain related to the incision site.
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   Rest inbed for about 2 hours after the procedure R: To minimize patient activity due to complication such as dyspnea.  Blood pressure and breathing will be checked for up to a few hours R: to make sure don't have complications
• 20.
   Pulmonary edema Respiratory distress  Air embolism  Bleeding  Infection  Dyspnea and cough  Atelectasis
• 21.
  Thank you