Thoracic puncture needle whole process

1. Instruct the patient to take the sitting position facing the back of the chair, place both forearms on the back of the chair, and forehead on the forearm. Those who cannot get up can take a semi-sitting position, with the affected side's forearm raised and hugged on the pillow.

2. The puncture point is selected at the most obvious part of the chest percussion. When there is more pleural fluid, the scapular line or the 7th to 8th intercostal space of the posterior axillary line are usually taken; sometimes the 6th to 7th intercostal space of the mid-axillary line or the 5th intercostal space of the anterior axillary line are also selected. It is the puncture point. The encapsulated effusion can be determined by X-ray or ultrasound. The puncture point is marked on the skin with a cotton swab dipped in nail purple (gentian purple).

3. Routinely disinfect the skin, wear sterile gloves and cover with a sterile hole towel.

4. Use 2% lidocaine to perform local infiltration anesthesia from the skin to the parietal layer of the pleura at the puncture point on the upper edge of the next rib.

5. The surgeon fixes the skin at the puncture site with the index finger and middle finger of the left hand, and turns the three-way stopcock of the puncture needle to the place where it closes to the chest cavity with the right hand. The three-way stopcock allows it to communicate with the chest cavity for drainage. The assistant uses a hemostatic forceps to help fix the puncture needle to prevent deep penetration of the lung tissue. After the syringe is full, turn the three-way stopcock to communicate with the outside world to drain the liquid.

6. At the end of the aspiration, pull out the puncture needle, cover it with sterile gauze, press it hard for a while, fix it with tape, and ask the patient to lie still.

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