Page 42 - Radiology Book

Paracentesis continued
ascites fluid
Color
Association
Translucent yellow
Normal/sterile
Brown
Hyperbilirubinemia, gallbladder, biliary perforation
Cloudy/turbid
Infection
Pink/blood-tinged
Trauma at site
Grossly bloody
Malignancy, abdominal trauma
Milky chylous
Cirrhosis, thoracic duct injury, lymphoma
tHoracentesis
All procedures require:
· Consent signed/placed in chart.
1. Decide on the tests to order and print labels. 2. Obtain all supplies.
3. “TIME OUT” document before procedure.
Prep Work
Supplies:
· Thoracentesis kit; sterile and nonsterile gloves. · 1-L vacuum bottle (careful; up to 1.5 L is safe).
· Betadine or chlorhexidine for skin prep.
· 5” × 5” gauze, 2 drapes/towels (Chux). Procedure
1. Position
· Seated and leaning over tabletop.
2. Landmarks
· Listen to the posterior chest to determine the site and size of the pleural effusion.
· Con rm effusion using US and mark the proper location just above the rib to avoid neurovascular structures.
· After cleaning and prepping, insert
the needle at the previous mark
until the uid is withdrawn. Hold
the needle in position and advance
the catheter. Withdraw the needle without advancing it further (to avoid lung trauma).
· Obtain a stat CXR after the procedure to rule out PTX.
Southfield16
Procedures