Thoracentesis / ˌ θ ɔː r ə s ɪ n ˈ t iː s ɪ s / , also known as thoracocentesis (from Greek θώραξ (thōrax, GEN thōrakos) 'chest, thorax ' and κέντησις (kentēsis) 'pricking, puncture'), pleural tap , needle thoracostomy , or needle decompression (often used term), is an invasive medical procedure to remove fluid or air from the pleural space for diagnostic or therapeutic purposes. A cannula , or hollow needle, is carefully introduced into the thorax, generally after administration of local anesthesia . The procedure was first performed by Morrill Wyman in 1850 and then described by Henry Ingersoll Bowditch in 1852.
19-660: Emergency correction of acute critical physiological disorders For the album by ADULT, see Resuscitation (album) . For the journal, see Resuscitation (journal) . [REDACTED] This article needs additional citations for verification . Please help improve this article by adding citations to reliable sources . Unsourced material may be challenged and removed. Find sources: "Resuscitation" – news · newspapers · books · scholar · JSTOR ( July 2023 ) ( Learn how and when to remove this message ) Resusitation
38-455: Is actually a compilation album of many of their earlier singles. A bulk of the songs are presented on Resuscitation in remixed or re-recorded forms. ADULT.'s members, Adam Lee Miller (music) and Nicola Kuperus (vocals and music) distributed the album on their own label, Ersatz Audio . Kuperus, a visual artist, is also responsible for the album's cover art photography. Thoracentesis The recommended location varies depending upon
57-400: Is common, this is also a common cause of pleural effusions. When cardiopulmonary status is compromised (i.e. when the fluid or air has its repercussions on the function of heart and lungs), due to air (significant pneumothorax ), fluid ( pleural fluid ) or blood ( hemothorax ) outside the lung, then this procedure is usually replaced with tube thoracostomy , the placement of a large tube in
76-401: Is defined as pleural fluid to serum total protein ratio of more than 0.5, pleural fluid to serum LDH ratio > 0.6, and absolute pleural fluid LDH > 200 IU or > 2 ⁄ 3 of the normal. An exudate is defined as pleural fluid that filters from the circulatory system into lesions or areas of inflammation. Its composition varies but generally includes water and the dissolved solutes of
95-460: Is different from Wikidata Articles needing additional references from July 2023 All articles needing additional references Pages displaying short descriptions with no spaces via Module:Annotated link Resuscitation (album) Resuscitation is a 2001 album released by American electronic music duo ADULT. Before this release, ADULT.'s output had consisted of various EPs and 12 inch singles released independently; this
114-2442: Is the process of correcting physiological disorders (such as lack of breathing or heartbeat) in an acutely ill patient. It is an important part of intensive care medicine , anesthesiology, trauma surgery and emergency medicine . Well-known examples are cardiopulmonary resuscitation and mouth-to-mouth resuscitation . Variables [ edit ] System Example causes Biomarker Treatment Hypoperfusion ( Circulatory shock ) Haemorrhagic shock Hypovolemia ( Hypovolemic shock ) Intravascular volume status ( Preload ) Heart rate ( Tachycardia ) / Systolic blood pressure ( Hypotension ) / Decreased urine output Intravenous fluid / Intraosseous infusion / Blood transfusion with packed red blood cells Cardiogenic shock Cardiac output Positive inotropic agents / Chronotropes Distributive shock Sepsis ( Septic shock ) Vascular permeability Vasopressors Neurogenic shock Total peripheral resistance Obstructive shock Cardiac tamponade Beck's triad Pericardiocentesis / Thoracotomy with pericardial window Tension pneumothorax Thoracentesis / Chest drain Pulmonary embolism Thrombolysis / Embolectomy Acid–base imbalance Acidosis pH Sodium bicarbonate Alkalosis Interventional/Supportive Gas exchange ( Respiratory failure ) Hypercapnia PaCO2 Interventional/Supportive Hypoxia PaO2 Oxygen therapy Altered level of consciousness Coma Narcosis ( Drug overdose ) / Stroke ( Intracranial hemorrhage ) Glasgow Coma Scale Interventional/Supportive Blood sugar regulation Hyperglycemia Blood sugar Insulin Hypoglycemia Glucose Electrolyte imbalance Hyperkalemia Serum potassium Calcium chloride / Calcium diglutamate , others Hypokalemia Potassium Coagulopathy Hypocoagulability Coagulation screen Fresh frozen plasma / Cryoprecipitate / Platelets See also [ edit ] [REDACTED] Look up resuscitation in Wiktionary,
133-487: Is uncertain as the volume removed does not correlate well with this complication. Major complications are pneumothorax (3–30%), hemopneumothorax , hemorrhage , hypotension (low blood pressure due to a vasovagal response) and reexpansion pulmonary edema . Minor complications include a dry tap (no fluid return), subcutaneous hematoma or seroma , anxiety, dyspnea and cough (after removing large volume of fluid). The use of ultrasound for needle guidance can minimize
152-1264: The Critically Ill Surgical Patient (CCrISP) Scoring systems NACA score Injury Severity Score [REDACTED] Category [REDACTED] Outline v t e Shock Distributive Septic shock Neurogenic shock Anaphylactic shock Toxic shock syndrome Obstructive Abdominal compartment syndrome Low-volume Hemorrhage Hypovolemia Osmotic shock Other Cardiogenic Spinal shock Cryptic shock Vasodilatory shock References [ edit ] ^ "Resusitation - an overview | ScienceDirect Topics" . www.sciencedirect.com . Retrieved 2023-07-30 . Authority control databases : National [REDACTED] Germany Czech Republic Retrieved from " https://en.wikipedia.org/w/index.php?title=Resuscitation&oldid=1258748026 " Categories : Critical emergency medicine Emergency medicine Intensive care medicine Hidden categories: Articles with short description Short description
171-442: The chest cavity outside the lung. In more than 90% of cases analysis of pleural fluid yields clinically useful information. If a large amount of fluid is present, then this procedure can also be used therapeutically to remove that fluid and improve patient comfort and lung function. The most common causes of pleural effusions are cancer , congestive heart failure , pneumonia , and recent surgery . In countries where tuberculosis
190-429: The complication rate. While chest X-ray has traditionally been performed to assess for pneumothorax following the procedure, it may no longer be necessary to do so in asymptomatic, non-ventilated persons given the widespread use of ultrasound to guide this procedure. Several diagnostic tools are available to determine the etiology of pleural fluid. First the fluid is either transudate or exudate . An exudate
209-685: The free dictionary. Advanced life support – Life-saving protocols Advanced cardiac life support – Emergency medical care Advanced trauma life support – American medical training program Cardiopulmonary resuscitation – Emergency procedure after sudden cardiac arrest Emergency Preservation and Resuscitation – Experimental emergency medicine procedure Fluid replacement , also known as Fluid resuscitation – Medical practice of replenishing bodily fluid Hs and Ts – Mnemonic Pages displaying short descriptions with no spaces Mouth-to-mouth resuscitation – Artificial ventilation using exhaled air from
SECTION 10
#1732851812625228-465: The main circulatory fluid such as blood. In the case of blood it will contain some or all plasma proteins, white blood cells, platelets and (in the case of local vascular damage) red blood cells. Exudate Transudate A high amylase level (twice the serum level or the absolute value is greater than 160 Somogy units) in the pleural fluid is indicative of either acute or chronic pancreatitis , pancreatic pseudocyst that has dissected or ruptured into
247-555: The pleural cavity) may be identified by determining triglyceride and cholesterol levels, which are relatively high in lymph . A triglyceride level over 110 mg/dl and the presence of chylomicrons indicate a chylous effusion . The appearance is generally milky but can be serous . The main cause for chylothorax is rupture of the thoracic duct , most frequently as a result of trauma or malignancy (such as lymphoma ). The number of white blood cells can give an indication of infection. The specific subtypes can also give clues as to
266-418: The pleural space, cancer or esophageal rupture. Glucose is considered low if pleural fluid value is less than 50% of normal serum value. The differential diagnosis for this is: Normal pleural fluid pH is approximately 7.60. A pleural fluid pH below 7.30 with normal arterial blood pH has the same differential diagnosis as low pleural fluid glucose. Chylothorax (fluid from lymph vessels leaking into
285-402: The pleural space. An uncooperative patient or a coagulation disorder that cannot be corrected are relative contraindications. Routine measurement of coagulation profiles is generally not indicated, however; when performed by an experienced operator "hemorrhagic complications are infrequent after ultrasound-guided thoracentesis, and attempting to correct an abnormal INR or platelet level before
304-456: The procedure is unlikely to confer any benefit". Relative contraindications include cases in which the site of insertion has known bullous emphysema , use of positive end-expiratory pressure (PEEP, see mechanical ventilation ) and only one functioning lung (due to diminished reserve). Traditional expert opinion suggests that the aspiration should not exceed 1 L to avoid the possible development of pulmonary edema, but this recommendation
323-6891: The rescuer Neonatal resuscitation – An emergency medical procedure Pediatric advanced life support – American Heart Association course v t e Intensive care medicine Health science Medicine Medical specialities Respiratory therapy General terms Intensive care unit (ICU) Neonatal intensive care unit (NICU) Pediatric intensive care unit (PICU) Coronary care unit (CCU) Critical illness insurance Geriatric intensive-care unit Conditions Organ system failure Shock sequence SIRS Sepsis Severe sepsis Septic shock Multiple organ dysfunction syndrome Other shock Cardiogenic shock Distributive shock Anaphylaxis Obstructive shock Neurogenic shock Spinal shock Vasodilatory shock Organ failure Acute renal failure Acute respiratory distress syndrome Acute liver failure Respiratory failure Multiple organ dysfunction syndrome Neonatal infection Polytrauma Coma Complications Critical illness polyneuropathy / myopathy Critical illness–related corticosteroid insufficiency Decubitus ulcers Fungemia Stress hyperglycemia Stress ulcer Iatrogenesis Methicillin-resistant Staphylococcus aureus Oxygen toxicity Refeeding syndrome Ventilator-associated lung injury Ventilator-associated pneumonia Dialytrauma Diagnosis Arterial blood gas Catheter Arterial line Central venous catheter Pulmonary artery catheter Blood cultures Screening cultures Life-supporting treatments Airway management and mechanical ventilation Tracheal intubation Cardiac devices Intra-aortic balloon pump Ventricular assist device Chest tube Kidney dialysis Early goal-directed therapy Induced coma Nutritional supplementation Enteral feeding Total parenteral nutrition Therapeutic hypothermia Drugs Analgesics Antibiotics Antithrombotics Inotropes Intravenous fluids Neuromuscular-blocking drugs Recombinant activated protein C Sedatives Stress ulcer prevention drugs Vasopressors ICU scoring systems APACHE II Glasgow Coma Scale PIM2 SAPS II SAPS III SOFA Physiology Hemodynamics Hypotension Level of consciousness Acid–base imbalance Water-electrolyte imbalance Organisations Society of Critical Care Medicine Surviving Sepsis Campaign European Society of Paediatric and Neonatal Intensive Care Related specialties Anesthesiology Internal medicine Cardiology Neurology Pulmonology Pediatrics Surgery Traumatology v t e Trauma Principles Polytrauma Major trauma Traumatology Triage Resuscitation Trauma triad of death Assessment Clinical prediction rules Abbreviated Injury Scale Injury Severity Score NACA score Revised Trauma Score Investigations Diagnostic peritoneal lavage Focused assessment with sonography for trauma Management Principles Advanced trauma life support Damage control surgery Early appropriate care Trauma center Trauma surgery Trauma team Procedures Resuscitative thoracotomy Pathophysiology Injury MSK Bone fracture Degloving Joint dislocation Soft tissue injury Respiratory Diaphragmatic rupture Flail chest Hemothorax Pneumothorax Pulmonary contusion Cardio Cardiac tamponade Internal bleeding Thoracic aorta injury GI Blunt kidney trauma Splenic injury Neuro Intracranial hemorrhage Penetrating head injury Traumatic brain injury Mechanism Blast injury Blunt trauma Burn Crush injury Electrocution Gunshot wound Penetrating trauma Stab wound Region Abdominal trauma Chest injury Facial trauma Head injury Spinal cord injury Demographic Geriatric trauma Pediatric trauma Complications Acute respiratory distress syndrome Chronic traumatic encephalopathy Compartment syndrome Contracture Volkmann's contracture Crush syndrome Rhabdomyolysis Embolism air fat Post-traumatic stress disorder Subcutaneous emphysema Wound healing v t e Emergency medicine Emergency medicine Emergency department Emergency medical services Emergency nursing Emergency psychiatry Golden hour Medical emergency International emergency medicine Pediatric emergency medicine Pre-hospital emergency medicine Major trauma Trauma center Triage Equipment Bag valve mask (BVM) Chest tube Defibrillation ( AED ICD ) Electrocardiogram (ECG/EKG) Intraosseous infusion (IO) Intravenous therapy (IV) Tracheal intubation Laryngeal tube Combitube Nasopharyngeal airway (NPA) Oropharyngeal airway (OPA) Pocket mask Drugs Adenosine Amiodarone Atropine Dopamine Epinephrine / Adrenaline Naloxone Magnesium sulfate Sodium bicarbonate Organisations International Federation for Emergency Medicine ( International Conference on Emergency Medicine ) American College of Emergency Physicians Australasian College for Emergency Medicine Canadian Association of Emergency Physicians Royal College of Emergency Medicine European Society for Emergency Medicine Asian Society for Emergency Medicine American Academy of Emergency Medicine Courses / Life support First aid Cardiopulmonary resuscitation (CPR) Mouth-to-mouth resuscitation Basic life support (BLS) Advanced cardiac life support (ACLS) Advanced trauma life support (ATLS) Neonatal Resuscitation Program (NRP) Acute Care of at-Risk Newborns (ACoRN) Pediatric basic life support (PBLS) Pediatric Advanced Life Support (PALS) Advanced Life Support in Obstetrics (ALSO) Care of
342-423: The source. Some sources recommend the midaxillary line , in the eighth, ninth, or tenth intercostal space . Whenever possible, the procedure should be performed under ultrasound guidance, which has shown to reduce complications. Tension pneumothorax is a medical emergency that requires needle decompression before a chest tube is placed. This procedure is indicated when unexplained fluid accumulates in
361-480: The type on infection. The amount of red blood cells are an obvious sign of bleeding. If the effusion is caused by infection , microbiological culture may yield the infectious organism responsible for the infection, sometimes before other cultures (e.g. blood cultures and sputum cultures) become positive. A Gram stain may give a rough indication of the causative organism. A Ziehl–Neelsen stain may identify tuberculosis or other mycobacterial diseases. Cytology
#624375