Thoracentesis

The thoracentesis is a special puncture in medicine. It usually after a local anesthetic, a needle into the pleural cavity, the gap space between the pleura and visceral pleura stabbed.

The method can only be performed when there is fluid in the pleural space. It is performed for diagnostic reasons ( procure specimens ) or therapeutic reasons ( relief of a larger pleural effusion ).

Usually, the method is applied under ultrasound guidance, to mark the exact location of the effusion before the puncture. The patient sits with her back to the doctor. Before the puncture, a local anesthetic should be injected into the skin and to the pleura. Dots in each case just above the upper edge of a rib to the avoid injury at the lower edge along pulling nerves, lymph and blood vessels.

A bilateral puncture is performed only in an emergency. Most will not be more than 1000-1200 ml tapped in with a puncture, otherwise a reactive pulmonary pressure and volume ratios can arise in response to the changed.

The thoracentesis is in the hands of an experienced physician, a simple and fast method to the person concerned to provide a relief, for example, in extensive effusions and dyspnea ( shortness of breath ).

After about two hours, radiographs should be made to exclude lung injury.

As with many punctures, a sufficient blood clotting in the patient should be secured. The prothrombin time should be above 50% and the platelet count be> 50000/μL.

Possible complications of the method

  • Infection (low in sterile needle and good skin disinfection risk )
  • Violation of the lungs with possible pneumothorax rare case of a large effusion
  • Common in chambered effusion or puncture lying

Source and References

  • Gernot Marx checklist Interdisciplinary intensive care. Georg Thieme Verlag, August 2009, ISBN 978-3-13-116913-6, pp. 67-8 (accessed 24 February 2012 ).
  • Diagnostic procedures in pneumology
  • Medical laboratory investigation procedure
  • Therapeutic procedures in pneumology
  • Invasive therapeutic procedures
  • Veterinary Medical Diagnostic
Hemostasis Spleen
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