As A Thoracentesis Is Performed

In a thoracentesis is a needle aspiration of fluid from a pleural effusion. It can be done for diagnosis or therapy. Indications Diagnostic thoracentesis: Indicated for almost all patients who have pleural fluid that is new or unknown etiology and ? 10 mm thickness on CT, ultrasound or x-ray in a lateral position has (diagnosis of pleural effusion) Therapeutic thoracentesis: Indicated to treat the symptoms in patients to relieve dyspnea which are caused by a large pleural effusion a diagnostic thoracentesis is not usually necessary when the etiology of the pleural fluid can be seen (z. B. viral pleurisy, typical heart failure). The selection of laboratory tests, typically conducted in pleural fluid, will be discussed in pleural effusion. When pleural fluid accumulates again after several therapeutic Thorakozentesen, pleurodesis can help (injection of an irritating substance into the pleural space) to prevent recurrence. Pleurodesis is most often performed to prevent reaccumulation of malignant effusions. Contraindications There are no absolute contraindications. Relative contraindications: bleeding disorder or anticoagulation Uncertain position of the liquid Minimum fluid volume Altered anatomy of the chest wall lung disease that is severe enough to life-threatening complications to cause uncontrolled coughing complications include the Hauptomplikationen pneumothorax bleeding (hemoptysis caused by lung puncture) pulmonary edema by re-expansion and / or hypotension (1) hemothorax due to damage to the intercostal vessels puncture of the spleen or liver vasovagal syncope If bloody Punktatflüssigkeit in the collection tube is not clot that an indication of a nichtiatroge ne of origin, as the fibrin is quickly consumed in a bloody pleural effusion. Equipment local anesthetic (for example 10 ml 1% lidocaine), 25 gauge and 20 to 22 gauge needles and 10 mL syringe Antiseptic solution applicators cover and gloves Pleurapunktionsnadel and plastic catheter 3-way stopcock 30 to 50 ml syringe wound dressing materials bedside for patients to lean Suitable containers (z. B. tubes with red and purple lid, blood culture bottles) to collect fluid for laboratory tests Evacuated container (vacuum bottle) or collection bag for the removal of larger quantities during therapeutic thoracentesis ultrasound device ( when the method is performed using ultrasound) Other considerations Pleurapunktionen can with reasonable certainty be performed on an outpatient basis at the bedside or. Plenty of local anesthetic is necessary, but a procedural sedation is not required for cooperative patients. A Pleurapunktionsnadel should not be introduced by infected skin (z. B. cellulitis or herpes zoster). Positive pressure support ventilation may increase the risk of complications. If the patient receives anticoagulant (eg. As warfarin), you want to consider before proceeding to give fresh frozen plasma or another antidote. If bloody Punktatflüssigkeit in the collection tube from clotting, which is an indication of a history of non origin, as the fibrin is quickly consumed in a bloody pleural effusion. Monitoring measures (such. As pulse oximetry and ECG) are required only for unstable patients and patients with a high risk of decompensation due to complications. Positioning This is best done on sitting upright patient slightly forward bent position with support on the arms. Pleurapunktionen in a lying position or in a supine position (z. B. in ventilated patients) are possible, but should be made better by ultrasound or CT guidance. Relevant Anatomy The intercostal neurovascular bundles of each rib is located along the lower edge. Therefore, the needle must be placed over the upper edge of the rib, in order to avoid damage to the neurovascular bundles. Liver and spleen can during exhalation to 5 intercostal space on the right side (liver) and increase to 9 intercostal on the left side (spleen) Anatomy of the ribs var model = {thumbnailUrl: ‘/ – / media / manual / ? professional / images / rib-anatomy-labels-video-2_de.jpg lang = en & thn = 0 & mw = 350 ‘, imageUrl:’ /-/media/manual/professional/images/rib-anatomy-labels-video-2_de.jpg ? lang = en & thn = 0 ‘, title:’ Anatomy of the ribs ‘, description:’ u003Ca id = “v38395355 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDas neurovascular bundle at the bottom of the rib comprises the intercostal Ven E.

Health Life Media Team

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