Thoracentesis procedure

(1) Routine skin disinfection: disinfect the skin around the puncture point, about 15 cm in diameter, twice.

(2) Open the disposable thoracic puncture bag, wear sterile gloves, cover the sterile hole towel, check the contents of the thoracic puncture bag, pay attention to whether the thoracic puncture needle is connected with the syringe for aspiration and check whether it is unobstructed, and check whether there is any air leakage at the same time .

(3) The assistant assisted in the inspection and opened the 2% lidocaine ampoule. The surgeon used 5ml and syringe to draw 2-3ml of 2% lidocaine, and performed local infiltration anesthesia from the epidermis to the pleural wall at the puncture site. If the puncture point is the scapular line or the posterior axillary line, insert the anesthesia needle between the ribs along the upper edge of the lower rib.

(4) Connect the chest piercing needle with the syringe for drawing fluid, and close the switch between the two to ensure that the closure is tight and air-tight. The surgeon uses the index finger of one hand and the middle finger to fix the skin of the puncture site, and the other hand holds the puncture needle to slowly pierce the anesthesia site. When the sharp sense of resistance of the needle disappears, turn on the switch to communicate with the thoracic cavity and draw fluid. The assistant uses hemostatic forceps (or spare forceps in the chest puncture bag) to assist in fixing the puncture needle to prevent the lung tissue from being penetrated too deeply. After the syringe is full, turn off the switch (the front of the syringe for drawing fluid in some chest piercing bags is designed with a one-way valve, or you don’t need to turn off the switch, depending on the specific situation) to drain the liquid into the drainage bag, and count the amount of fluid drawn. .

(5) Pull out the puncture needle at the end of the aspiration, disinfect locally, cover it with sterile gauze, press it hard for a while, and fix it with tape.

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