PARACENTESIS

 

1. Indicated for diagnostic purposes or dyspnea.

2. The ideal  site is halfway between umbilicus and iliac crest on the left side.

3. Site of procedure is prepped and anesthetized.

4. Fluid is aspirated to ascertain proper location. One end of  IV tubing is attached to the needle and the other end to a vacuum bottle.  Drain.

5. Fluid is sent for :

  1. Tube #1-  LDH, Glucose, Protein, albumin, amylase
  2. Tube#2 - C&S.
  3. Tube #3 - cell count.
  4. Tube #4 - cultures (in blood culture bottles), AFB, Gram stain and other as needed.
     

6. At  the same time, blood must be drawn for LDH and protein and ratio between the two is performed. Results are as Thoracentesis (see Pl. Effusion).

7. When performed for therapeutic purposes, risk of hypotension exists for aspirations greater than  1-1.5  liters of ascitic fluid.  Patients should be carefully monitored in these settings.

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