PLEURAL DRAINAGE

Indications for use

· pneumothorax

· tension pneumothorax

· haemothorax

· large symptomatic pleural effusion

Pleural Tap

A once only drainage procedure using a large bore needle or small catheter under local anaesthesia, and using a sterile technique.

Dwellcath technique

Utilizes a 3 way tap attached to a 12G Dwellcath, syringe and tubing in a closed system, to aspirate pleural effusion.

Seldinger technique

Utilizes a guidewire inserted through a needle into the pleural space, then a catheter is threaded over the wire through which to aspirate.

Pleural tap and aspiration

Equipment

Sterile H.S.D.U. Pleural Biopsy tray containing 50ml luer lock syringe, 2 ml luer lock syringe, 2 forceps, 1 length of tubing, 1 dressing towel, 1 area towel, 10 gauze swabs, no11 blade and a 3 way stopcock

Additional Equipment Sterile gown and gloves, persist plus swabs or povidone iodine solution, lignocaine 1% (2 x 5 ml), size 12 dwellcath, sterile measure jug, 2 laboratory specimen bottles (citrated) and adhesive tape.

Procedure

· prepare the patient

· a written consent is required

· the patient is positioned as per medical direction making sure he/she is adequately supported

· the nurse assists with the procedure

· label specimen bottles and send to the IMVS as required

· the puncture site is observed hourly for four hours after the procedure and any excessive ooze is reported

· chest x-ray if ordered