slides showing the procedure for paracentesis

2. PARACENTESIS
PRESENTED BY
APARNA C LAKSHMY

4. DEFINITION
◦PARACENTESIS IS THE REMOVAL OF FLUID
FROM THE ABDOMINAL CAVITY(PERITONIUM)
TO REDUCE INTRA-ABDOMINAL TENSION IN
PATIENT WITH RESPIRTORY COMPROMISE
AND TENSION ASCITES OR OBTAIN FLUID
FOR CULTURE.
◦IT IS ALSO CALLED PERITONEAL TAP

6. ◦ABDOMINAL PARACENTESIS IS THE
PUNCTURE OF THE ABDOMINAL WALL
WITH THE AN ABDOMINAL TROCHAR AND
CANNULA

7. INDICATION
◦TO RELIEVE PRESSURE ON THE ABDOMINAL AND CHEST ORGANS
DUE TO ASCITES
◦TO STUDY CHEMICAL,BACTERIOLOGICAL AND CELLULAR
COMPOSITION OF PERITONEAL FLUID FOR DIAGNOSIS OF
DISEASE
◦TO DRAIN EXUDATE IN PERITONITIS

8. ◦TO PREPARE FOR PROCEDURES LIKE PERITONEAL DIALYSIS
◦TO STUDY CELL COUNT,GRAM STAIN,MICROSCOPY AND CULTURE
◦TO REMOVE FLUID AND INSTILL AIR TO CREATE ARTIFICAL
PNEUMOPERITONEUM AS TREATED FOR PULMONARY
TUBERCULOSIS AFFECTING BASE OF LUNG.

10. ARTICLES
◦A STERILE TRAY CONTAINING:
◦SPONGE HOLDING FORCEPS
◦5 ML SYRINGE
◦20 ML SYRINGE
◦BETADINE SOLUTION

11. ◦THREE WAY ADAPTER AND TUBING
◦SMALL BOWLS
◦SPECIMEN BOTTLE
◦STERILE DRESSING PACK
◦COTTON BALLS

14. A CLEAN TRAY CONTAINING:
◦MACKINTOSH AND DRAW SHEET
◦INJECTION 2 % LIGNOCAINE
◦INTRAVENOUS SET
◦KIDNEY TRAY AND PAPER BAG.

15. PROCEDURE
◦PREPROCEDURAL STEPS
IDENTIFY THE PATIENT AND EXPLAIN THE PROCEDURE TO
THE PATIENT AND RELATIVES
MEASURE ABDOMOINAL GIRTH AND WEIGHT OF THE
PATIENT
OBTAIN INFORMED CONSENT

16. ASK THE PATIENT TO CATHETERISE
FOLLOW STRICT ASEPTIC TECHNIQUES
PLACE THE SCREEN
PREPARE THE SKIN FROM NIPPLE TO PELVIS
RECORD VITAL SIGNS
KEEP THE PATIENT WARM AND COMFORTABLE
KEEP DRUGS AND EQUIPMENTS READY TO TREAT SHOCK

17. INTRA PROCEDURAL STEPS
◦EXPOSE THE AREA BELOW THE NIPPLE TO THE PUBIC AREA TO
MINIMIZE EXPOSURE OF THE PATIENT
◦PLACE THE PATIENT IN SUPINE POSITION
◦PLACE THE MACKINTOSH
◦WASH HANDS AND OPEN THE STERILE FIELD
◦

18. ASSIST THE PHYSICIAN IN INSERTING THE TROCAR AND CANNULA BELOW THE
UMBILICUS.
REMOVE THE TOCAR
PLACE THE RUBBER TUBING INTO A STERILE PINT ,MEASURE AND ADJUST THE RATE
OF FLOW WITH A SCREW CLAMP TO MEASURE THE DRAINED OUT FLUID AND
PREVENT CROSS INJECTION
AFTER ENOUGH FLUID IS WITHDRAWN , REMOVE THE CANNULA
 PLACE STERILE DRESSING AND PRESSURE BANDAGE OVER THE PUNCTURE SITE
PLACE THE PATIENT IN COMFORTABLE POSITION

19. POST PROCEDURAL STEPS
◦TIDY UP THE UNIT AFTER MAKING THE PATIENT
COMFORTABLE
◦RECORD THE AMOUNT OF FLUID REMOVED AND ITS
CHARACTERISTICS TO MEASURE ACCURATELY
◦CHECK THE VITAL SIGNS
◦OBSERVE THE DRESSING
◦