Perioperative Nursing Coordination And Infection Control Management For Chiba Needles

From Preoperative Item Preparation to Postoperative Needle Tract Complication Management

https://radiopaedia.org/articles/chiba-needle

Although the Chiba needle is a minimally invasive fine needle, its nursing coordination and infection control directly affect the biopsy positivity rate and patient safety.

Preoperative Preparation

• Item Verification:​ Prepare Chiba needles (matching specifications), 10 mL/20 mL syringes (negative pressure source), microscope slides/fixatives (cytology), disinfectant, local anesthetic, sterile drapes, ultrasound coupling gel (if US-guided), or CT positioning grids according to the procedure. Verify product expiration dates, packaging integrity, and the scope of application on the registration certificate.
• Patient Preparation:​ Verify coagulation function (INR <1.5, PLT >50×10⁹/L), fasting requirements (PTBD/deep liver puncture often requires 4–6 hours of fasting), breath-holding training (mandatory for lung/liver puncture), and obtain signed informed consent.
• Intraoperative Coordination
• Assist the operator with draping, passing the needle, and attaching the syringe to maintain moderate negative pressure (remind not to aspirate too forcefully to avoid hemolysis);
• In US guidance, hold the probe to display the lesion and remind of the needle tip position; in CT guidance, assist in marking the entry point and instructing the patient to hold their breath;
• Specimen Handling:​ Immediately smear FNA specimens upon withdrawal (even, thin layer) and fix in 95% ethanol; if preparing a cell block, inject into cell preservation fluid, centrifuge, and embed.

Postoperative Observation and Complication Management

• General Observation:​ Apply pressure to the puncture site for hemostasis, cover with a dressing. After lung puncture, keep the patient bedridden for 2–4 hours and review a chest X-ray; after liver/kidney puncture, monitor blood pressure, abdominal signs, and urine color.
• Management of Common Complications:
• Mild Pneumothorax​ (lung compression <30%, asymptomatic): Oxygen observation, mostly resolves spontaneously; large volume or symptomatic: closed chest drainage.
• Needle Tract Oozing:​ Local pressure for 5–10 minutes, sandbag if necessary; persistent bleeding with blood pressure fluctuations requires ultrasound/CT to rule out active bleeding.
• Biliary Peritonitis/Biliary Bleeding (after PTC):​ Observe abdominal pain, peritoneal irritation signs, and drainage fluid characteristics; promptly adjust drainage tube position or intervene.
• Medical Waste and Sharps Safety:​ Immediately place the used Chiba needle into a puncture-resistant sharps container after use. Do not recap the needle with both hands. Dispose of it as infectious medical waste.

Standardized nursing coordination can minimize unnecessary failure rates (unsatisfactory specimens, preventable complications) of Chiba needle procedures, serving as a crucial component for the efficient operation of interventional teams.