Diagnostic or therapeutic drainage of pleural fluid.
Indications
- • New pleural effusion (diagnostic)
- • Symptomatic effusion (therapeutic)
Contraindications
- ⚠ Coagulopathy (INR > 1.5)
- ⚠ Platelets < 50
- ⚠ Skin infection at site
Equipment
- • USG (recommended)
- • Sterile kit
- • Local anesthetic
- • 50 mL syringe + 3-way tap
- • 18-G needle or pigtail
- • Collection bottles for biochem/micro/cyto
Positioning
- • Sitting, leaning forward on bedside table.
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 (0/6)
Tap to complete
USG-guided; typically posterior axillary line 1–2 ICS below upper level of effusion, above 8th rib.
Immediate complications
- ⚠ Pneumothorax
- ⚠ Bleeding
- ⚠ Re-expansion pulmonary edema
- ⚠ Vasovagal
Delayed complications
- • Infection
Recognition
- • Cough, dyspnea, hypoxia
Initial management
- • Stop; CXR; O2
Prevention
- • USG guidance
- • Limit volume
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.
