c. Preparation for the Procedure.
(1) Check clinical record for signed SF 522 (Authorization for Administration
of Anesthesia and for Performance of Operations and Other Procedures).
Obtain chest X-rays, if requested.
(3) Explain the procedure to the patient, stressing the importance of
remaining immobile during the procedure.
Take and record TPR and blood pressure (BP).
(5) Screen the patient. Remove pajama jacket to expose chest. The site of
the puncture will depend upon the location of the fluid or air that is to be aspirated.
(6) Position the patient as directed by the physician. The position may be
either one of the following or a similar position, as directed by the physician.
(a) Seat the patient on the side of the bed, facing away from the
physician, with feet supported on a chair and the head and arms resting on an overbed
table padded with pillows. The arms are elevated slightly to widen the intercostal
(b) Place the patient in a semi recumbent position, facing away from
the physician, resting on the non-affected side, with the head of the bed elevated about
45 degrees. A pillow is placed under the chest to widen the intercostal spaces. The
arm of the affected side is placed above the head to elevate the ribs, thereby making
the insertion of the needle easier.
d. Assisting with Thoracentesis.
(1) Place the thoracentesis tray on instrument table. Open sterile wrapper
cover to provide a sterile field.
(2) Place other supplies on adjacent bedside stand or over bed table. Open
(3) Assist with handling of local anesthetic vial. Hold vial with label
uppermost so that the physician can personally check the label before withdrawing any
of the solution. Cleanse stopper with alcohol sponge. Invert vial and hold firmly while
the doctor, with gloved hands, withdraws the required solution.
(4) Support and help patient to avoid moving and coughing while the
thoracentesis needle is introduced.
(5) Assist as directed with collection of specimens as the physician
manipulates the syringe, the stopcock, and drainage tubing. Use care not to