Paracentesis is a procedure to remove fluid from the abdominal cavity through puncturing the abdominal wall. It relieves pressure on abdominal and chest organs from fluid buildup. The key steps are preparing the patient, inserting a trocar and cannula below the umbilicus to drain fluid, and applying a dressing to the puncture site after removing sufficient fluid. The procedure aims to diagnose conditions causing fluid accumulation and reduce respiratory distress.

2. PARACENTESIS
PRESENTED BY
APARNA C LAKSHMY

4. DEFINITION
◦PARACENTESIS IS THE REMOVAL OF FLUID
FROM THE ABDOMINAL CAVITY(PERITONIUM)
TO REDUCE INTRA-ABDOMINAL TENSION IN
PATIENT WITH RESPIRTORY COMPROMISE
AND TENSION ASCITES OR OBTAIN FLUID
FOR CULTURE.
◦IT IS ALSO CALLED PERITONEAL TAP

6. ◦ABDOMINAL PARACENTESIS IS THE
PUNCTURE OF THE ABDOMINAL WALL
WITH THE AN ABDOMINAL TROCHAR AND
CANNULA

7. INDICATION
◦TO RELIEVE PRESSURE ON THE ABDOMINAL AND CHEST ORGANS
DUE TO ASCITES
◦TO STUDY CHEMICAL,BACTERIOLOGICAL AND CELLULAR
COMPOSITION OF PERITONEAL FLUID FOR DIAGNOSIS OF
DISEASE
◦TO DRAIN EXUDATE IN PERITONITIS

8. ◦TO PREPARE FOR PROCEDURES LIKE PERITONEAL DIALYSIS
◦TO STUDY CELL COUNT,GRAM STAIN,MICROSCOPY AND CULTURE
◦TO REMOVE FLUID AND INSTILL AIR TO CREATE ARTIFICAL
PNEUMOPERITONEUM AS TREATED FOR PULMONARY
TUBERCULOSIS AFFECTING BASE OF LUNG.

10. ARTICLES
◦A STERILE TRAY CONTAINING:
◦SPONGE HOLDING FORCEPS
◦5 ML SYRINGE
◦20 ML SYRINGE
◦BETADINE SOLUTION

11. ◦THREE WAY ADAPTER AND TUBING
◦SMALL BOWLS
◦SPECIMEN BOTTLE
◦STERILE DRESSING PACK
◦COTTON BALLS

14. A CLEAN TRAY CONTAINING:
◦MACKINTOSH AND DRAW SHEET
◦INJECTION 2 % LIGNOCAINE
◦INTRAVENOUS SET
◦KIDNEY TRAY AND PAPER BAG.

15. PROCEDURE
◦PREPROCEDURAL STEPS
IDENTIFY THE PATIENT AND EXPLAIN THE PROCEDURE TO
THE PATIENT AND RELATIVES
MEASURE ABDOMOINAL GIRTH AND WEIGHT OF THE
PATIENT
OBTAIN INFORMED CONSENT

16. ASK THE PATIENT TO CATHETERISE
FOLLOW STRICT ASEPTIC TECHNIQUES
PLACE THE SCREEN
PREPARE THE SKIN FROM NIPPLE TO PELVIS
RECORD VITAL SIGNS
KEEP THE PATIENT WARM AND COMFORTABLE
KEEP DRUGS AND EQUIPMENTS READY TO TREAT SHOCK

17. INTRA PROCEDURAL STEPS
◦EXPOSE THE AREA BELOW THE NIPPLE TO THE PUBIC AREA TO
MINIMIZE EXPOSURE OF THE PATIENT
◦PLACE THE PATIENT IN SUPINE POSITION
◦PLACE THE MACKINTOSH
◦WASH HANDS AND OPEN THE STERILE FIELD
◦

18. ASSIST THE PHYSICIAN IN INSERTING THE TROCAR AND CANNULA BELOW THE
UMBILICUS.
REMOVE THE TOCAR
PLACE THE RUBBER TUBING INTO A STERILE PINT ,MEASURE AND ADJUST THE RATE
OF FLOW WITH A SCREW CLAMP TO MEASURE THE DRAINED OUT FLUID AND
PREVENT CROSS INJECTION
AFTER ENOUGH FLUID IS WITHDRAWN , REMOVE THE CANNULA
 PLACE STERILE DRESSING AND PRESSURE BANDAGE OVER THE PUNCTURE SITE
PLACE THE PATIENT IN COMFORTABLE POSITION

19. POST PROCEDURAL STEPS
◦TIDY UP THE UNIT AFTER MAKING THE PATIENT
COMFORTABLE
◦RECORD THE AMOUNT OF FLUID REMOVED AND ITS
CHARACTERISTICS TO MEASURE ACCURATELY
◦CHECK THE VITAL SIGNS
◦OBSERVE THE DRESSING
◦