Pleural puncture needle three: method

Be familiar with the patient's condition. 2. Talk with the patient and his/her family, inform them of the purpose of the examination, general process, possible complications, etc., and sign the informed consent for surgery. 3. Equipment preparation, such as pleural puncture kit, sterile thoracic drainage and drainage bottle, etc. 1. Body position The patient takes the sitting position facing the back chair, with both forearms on the back of the chair and forehead bent over the forearms. For patients unable to get up and pneumothorax, it is advisable to sit in a semi-seated position with the patient's forearm raised and held in the occipital. 2. Puncture site should be selected at the most obvious part of the chest percussion sound (or drum sound) for puncture. 1. Open the disposable chest puncture kit, put on sterile gloves, cover the sterile hole towel, and check the contents of the puncture kit. Check whether the chest puncture needle is smooth after being connected with the syringe used for pumping fluid, and check whether there is air leakage. 2 ~ 3ml of 2% lidocaine was extracted with a 5ml syringe, and local infiltration anesthesia was performed from epidermis to parietal pleura at the puncture site. If the puncture point is scapular line or posterior axillary line, the anesthetic needle is inserted along the upper edge of the lower rib in the intercostal area. If the puncture point is midaxillary line or anterior axillary line, the needle is inserted between the two ribs. 1 connect the chest puncture needle with the rubber tube, and close the switch between the two to ensure tight closure without air leakage. The surgeon fixes the skin at the puncture site with the left finger and middle finger, and holds the puncture needle in the right hand and slowly penetrates it along the anesthetic site. When the resistance of the needle front to sensation disappears, open the switch and connect it with the chest cavity for suction. An assistant uses hemostatic forceps to help secure the needle. After the syringe is filled, turn off the switch to drain the liquid into the drainage bag, count the amount of liquid (gas) pumped. 1. After the pumping, pull out the needle, sterilize the area, cover the sterile gauze, press the needle for a moment, and then fix the syringe with adhesive tape and ask the patient to lie still. 1. The purpose of puncture should be explained to the patient before operation to eliminate concerns. 2. The patient's reaction should be closely observed during the operation. 3. Do not pump too much or too fast at one time. 4. Strict aseptic operation should always keep negative pleural pressure during operation to prevent air from entering the chest cavity. 5. Avoid puncture below the 9th intercostal space. 6. Measure the patient's vital signs before and after the operation, and ask the patient to lie down and rest for 30 minutes after the operation. 7. For malignant pleural effusion, anti-tumor drugs or hardeners can be injected to induce chemical pleuritis, so as to promote adhesion between the visceral layer and the parietal pleura, close the chest and prevent the re-accumulation of pleural effusion. five

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