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THORACENTESIS and its procedure, purposes, indication, contraindications
- 1. THORACENTESIS PREPARED BY :-MRNITHIN HIREMATH
- 2. DEFINITION :- • Thoracentesisis a procedure to remove fluid from the space between the lungs and the chest wall called the pleural space • Thoracentesis is a percutaneous procedure during which a needle is inserted intothe pleural space and pleural fluid is removed either through the needle or catheter
- 3. PURPOSE • To determinethe cause of abnormal accumulation of fluid in the pleural space • Relieve shortness of breath and pain • As a diagnostic or treatment procedure • To drain large amounts of pleural fluid • To equalize pressure on both sides of the thoracic cavity
- 4. INDICATION :- • Plurealeffusion • Emphysema • Hemothorax • Pneumothorax
- 7. PRE-PROCEDURAL NURSING RESPONSIBILITIES •Explain Procedure to Patient: Purpose, risks, and how it will be done Obtain informed consent • Check Investigations: Chest X-ray or ultrasound Coagulation profile (platelet count) to minimize bleeding risk. • Prepare Equipment: Sterile thoracentesis kit Antiseptic solution (chlorhexidine or povidone- iodine)Local anesthetic (e.g., lidocaine)Syringes, needles, collection bottles, dressing materials Oxygen if needed • Position the Patient: Sitting upright with arms resting on an overbed table or pillow If unable to sit: lateral decubitus position with affected side up
- 8. DURING THE PROCEDURE:- • During the Procedure (Nursing Role)1. Assist Physician: Maintain sterile fieldhand over instruments as needed Monitor vital signs and oxygen saturation • Observe for Signs of Complications: Coughing, chest pain, dyspnea, hypotension Rapid or irregular pulse • Reassure and Comfort the Patient: Encourage slow, steady breathing Instruct to remain still to avoid injury. • Label specimen correctly and send them promptly to the laboratory for analysis.
- 9. POST-PROCEDURAL NURSING CARE:- • Monitor Patient: Vitals every 15 minutes for first hour Respiratory rate, breath sounds, oxygen saturation Observe for signs of pneumothorax or bleeding • Send Samples to Lab: Label properly (cytology, microbiology, biochemistry) • Apply Dressing: Sterile occlusive dressing at puncture site • Post-Procedural Chest X-ray: To rule out pneumothorax or lung injury • Documentation: Amount and type of fluid removed Patient's tolerance to procedure Any complications Time and site of puncture
- 10. COMPLICATIONTOWATCH • Pneumothorax • Hemothorax •Infection at puncture site • Air embolism (rare)
- 11. CONTRAINDICATION :- • pneumothorax •Uncooperative patient • Bleeding disorders or anticoagulant therapy • Local infection at puncture site • Pulmonary edema