Precautions For Using Pleural Puncture Needle

Precautions for using pleural puncture needle

1. The purpose of the puncture should be explained to the patient before the operation to eliminate concerns; for the mentally stressed, an appropriate amount of sedatives can be applied before the operation.

2. During the operation, the patient’s reaction should be closely observed. If there is dizziness, pale complexion, sweating, heart palpitations, chest pressure or severe pain, fainting and other pleural allergic reactions; or continuous coughing, shortness of breath, coughing up foamy sputum, etc., immediately Stop pumping fluid, and subcutaneously inject 0.3-0.5ml of 0.1% epinephrine, or perform other symptomatic treatment.

3. Pumping fluid should not be too much or too fast at one time. For diagnostic fluid extraction, 50-100ml is sufficient; for decompression fluid extraction, the fluid should not exceed 600ml for the first time and 1000ml each time thereafter; if it is empyema, try to draw as much fluid as possible each time. When a purulent infection is suspected, the assistant uses a sterile test tube to collect the specimen, and conducts smear Gram stain microscopy, bacterial culture, and drug susceptibility test. Check the tumor cells, at least 100ml, and should be submitted immediately to avoid cell autolysis.

4. During the operation, prevent air from entering the chest cavity and always maintain negative pressure in the chest cavity.

5. The puncture below the 9th intercostal space should be avoided to avoid penetrating the septum muscle and damaging the abdominal organs.

6. Malignant pleural effusion can be injected with antitumor drugs or injection of sclerosing agent to induce chemical pleurisy, promote adhesion between the visceral layer and parietal pleura, close the chest cavity, and prevent the re-accumulation of pleural fluid. The specific method is to dilute the medicine with 20-30 ml of normal saline after pumping 500-1200ml of fluid and then inject it. After pushing in the medicine, draw back the pleural fluid, push it in again, repeat 2-3 times, pull out the puncture needle to cover and fix, ask the patient to stay in bed for 2-4 hours, and constantly change the position, so that the medicine is evenly spread in the chest cavity. If the injection of drugs is irritating, it can cause chest pain. Analgesics such as strong pain should be given before surgery.

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