Ascitic Tap (Diagnostic Paracentesis)

General · Medicine · 10–20 min

Diagnostic sampling of ascitic fluid.

Indications

  • New ascites
  • Rule out SBP
  • Cause workup

Contraindications

  • Coagulopathy (relative)
  • Cellulitis at site
  • Distended bowel loops

Equipment

  • 21-G needle + 20 mL syringe
  • Sterile kit
  • Sample tubes

Positioning

  • Supine, tilted slightly to side of tap.

Consent

  • Explain indication, benefits, alternatives
  • Explain risks & complications
  • Obtain written/verbal consent as per SOP
  • Document consent

Universal precautions

  • Hand hygiene
  • PPE — gloves, mask, eye protection
  • Aseptic technique
  • Sharps safety
  • Verify patient identity & site

Step-by-step (0/5)

Tap to complete

1. Site

LIF (McBurney's mirror) — 2 finger-breadths above and medial to left ASIS.

Pearl: USG-guided is safer

2. Sterile prep & local

3. Advance needle

4. Aspirate

5. Withdraw & dressing

Immediate complications

  • Bleeding
  • Bowel perforation
  • Persistent leak

Delayed complications

  • Infection

Recognition

  • Continued leak, pain

Initial management

  • Pressure; suture if needed

Prevention

  • USG guidance
  • Z-track

Post-procedure observation

  • Vitals q15min × 1h then hourly

Monitoring

  • Site inspection
  • Symptom review

Documentation

  • Procedure note
  • Consent
  • Findings

Patient instructions

  • Report pain, bleeding, fever, worsening symptoms

Educational bedside guide. Perform only under supervision until competent. Follow local SOPs and consent policy.

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