Therapeutic Paracentesis

General · Medicine · 30–60 min

Large-volume drainage of ascites for symptomatic relief in tense/refractory ascites.

Indications

  • • Tense ascites
  • • Diuretic-resistant ascites

Contraindications

  • ⚠ As diagnostic tap
  • ⚠ Uncorrected coagulopathy

Equipment

  • • Paracentesis catheter or IV cannula 14–16 G
  • • Drainage bag/bottle
  • • Albumin (6–8 g per L removed if > 5 L)

Positioning

  • • As appropriate for the procedure and patient comfort.

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

As for diagnostic tap; USG mark.

Immediate complications

  • ⚠ Hypotension
  • ⚠ Post-paracentesis circulatory dysfunction
  • ⚠ Bleeding

Delayed complications

  • • Renal impairment
  • • Hyponatremia

Recognition

  • • Falling BP, urine output

Initial management

  • • Albumin, IV fluid; stop drain

Prevention

  • • Albumin replacement
  • • Slow drainage

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.

WardRound

WardRound

Clinical Decisions in Seconds