Thoracentesis Archives - Hospital Procedures Consultants

When Should You Stop Using Chest Tubes?

Thoracostomy or the insertion of chest tubes (CTs) is a frequent procedure in clinical practices. After inserting chest tubes in the patient’s pleural cavity, they become a route for administering antibiotics, sclerosing agents, fibrinolytics, and saline. Meanwhile, indwelling pleural catheters…

Role of Ultrasound in Lumbar Punctures

For procedures involving lumbar punctures , sonographically guided lumbar punctures (SGLPs) have a higher propensity of being chosen when dealing with obese patients. This is based on findings of a randomized controlled trial conducted in 2007. The main takeaway from…

Conscious Sedation. What It Is, When to Apply It, and the Latest Updates

Conscious sedation, also known as procedural sedation, is a common practice in emergency departments for patients undergoing painful or anxiety-provoking procedures. It is intended as a less invasive method. Generally, those who undergo this type of sedation can recover more…

Basic Emergency Procedures You Should Know

Physicians, physician associates (PAs), and nurse practitioners (NPs) need to be adept in a range of essential medical emergency procedures that they must perform in an inpatient settings. These bedside procedures are accomplished readily, but only if you have the…

Live CME Course vs Online CME Course. Which One to Choose?

A Continuing Medical Education (CME) Course is designed for doctors, nurses, nurse practitioners, physician associates and other healthcare professionals who want to learn more about certain topics in medicine. The primary goal of CME is to improve the quality of…

Looking To Work in the ER? Here Are Its Benefits, Challenges, and What To Expect

The emergency room (ER) is an essential area of any hospital because it often deals with life-and-death situations. How medical personnel respond significantly affects the prognosis of patients who are in need of urgent care. As a medical professional, experience…

Dispelling Myths about Thoracentesis and Pleural Fluid Analysis

Joseph Esherick, M.D., FAAFP, FHM

October 25, 2022

More Articles – BNP, Chest Pain, CHF, diuretics, exudate, Featured, Heart failure, HPC Updates, pleural effusions, pleural fluid analysis, Pleural space, re-expansion pulmonary edema, Thoracentesis, transudate, Ultrasound-Guided Thoracentesis

More Tags – CHF, diuretics, exudate, featured, HPC updates, Light's criteria, pleural effusions, pleural fluid analysis, re-expansion pulmonary edema, thoracentesis, transudate

There are two myths that have persisted about thoracentesis and pleural fluid analysis that must be dispelled. The first myth is that a large volume thoracentesis should not remove more than 1,500 mL fluid due to the risk of re-expansion…

What is the true complication rate for thoracentesis?

Joseph Esherick, M.D., FAAFP, FHM

October 25, 2022

More Articles – Featured Procedure, HPC Updates, pleural effusions, pleural fluid analysis, Pneumothorax, re-expansion pulmonary edema, Thoracentesis, ultrasound-guided procedures, Ultrasound-Guided Thoracentesis

More Tags – featured procedure, hemothorax, HPC updates, pneumothorax, re-expansion pulmonary edema, thoracentesis, thoracentesis complications, ultrasound-guided procedures

Thoracentesis is one of the most common bedside procedures performed in U.S. hospitals. There are about 173,000 thoracenteses performed each year in the U.S. A systematic review and meta-analysis in 2010 concluded that thoracentesis-related pneumothorax occurs 6% of the time…

The Case for Simulation Based Training for Bedside Hospital Procedures

Dr. Rick Rutherford, M.D., FAAFP

August 7, 2022

More Articles – Central Line, Central line insertion, central line placement, central lines, Central Venous Catheter, central venous catheters, E-FAST, emergency procedures, emergency procedures course, FAST exam, Featured, First-attempt success rate, hospital procedures, hospital procedures course, Hospitalist, HPC, HPC Conference, HPC Updates, Lumbar Puncture, medical procedures, medical procedures course, paracentesis, Paracentesis, POCUS, safety checklists, Simulation Based Training, Simulation-based procedural training, Thoracentesis, Ultrasound, Ultrasound for Pneumothorax, Ultrasound-Guided Central Line Insertion, Ultrasound-guided lumbar puncture, Ultrasound-Guided Lumbar Punctures, Ultrasound-Guided Paracentesis, ultrasound-guided procedures, Ultrasound-Guided Thoracentesis

More Tags – E-FAST, featured, HPC updates, lumbar puncture, paracentesis, POCUS, RUSH Exams, Simulation Based Training; Central Line Training, simulation-based procedural training, thoracentesis, Vascular access

For decades the mantra for procedural education in medicine has been “see one-do one-teach one”. Those of us who learned bedside procedures and point-of-care ultrasound by this model understand that this approach does not optimize safe and competent performance. At…

Pearls about Chest Tube Management

Chest tubes, or thoracostomy tubes, have been used since the fifth century BC when Hippocrates described the use of a hollow tin tube to drain fluid that was likely an empyema from his description.[i] Chest tubes started to be used…

Procedural Competency in Academic Emergency Medicine Attending Physicians

A recent article summarizes a cross-sectional survey aimed at determining the processes in place to assess the procedural competency of academic emergency medicine attendings.[i] The survey was sent to the 39 ACGME-accredited Emergency Medicine programs in the U.S. and had…

Periprocedural Bleeding Risk for Thrombocytopenia, Coagulopathy, Antiplatelets and Anticoagulation

Joseph Esherick, M.D., FAAFP, FHM

October 25, 2021

More Articles – Anticoagulation, antiplatelets, central lines, Chest tube, chest tubes, coagulopathy, Featured Procedure, HPC Updates, Lumbar Puncture, Paracentesis, procedures, Thoracentesis

More Tags – anticoagulation, antiplatelets, central lines, chest tubes, coagulopathy, featured procedure, HPC updates, lumbar puncture, paracentesis, procedures, thoracentesis

This blog summarizes the 2019 Society of Interventional Radiology (SIR) for Periprocedural Management of Image-guided Procedures with regards to thrombocytopenia, coagulopathies, antiplatelets and anticoagulation. The SIR guidelines are summarized as follows: Anticoagulation with heparin, LMWH, fondaparinux, argatroban, warfarin, DOAC, clopidogrel, ticagrelor…

Recommendations for Invasive Hospital Procedures in Patients with Cirrhosis

Joseph Esherick, M.D., FAAFP, FHM

October 25, 2021

More Articles – acute kidney injury, Arterial Line, Arterial line insertion, Arterial line placement, Arterial Lines, Central Line, Central line insertion, central line placement, central lines, Central Venous Catheter, central venous catheters, Chest tube, chest tube placement, Cirrhosis, Featured, hospital procedures, HPC Updates, Paracentesis, paracentesis, Procedures in Cirrhotic Patients, Radial Artery Catheterization, Sepsis, Small-bore chest tube, Spontaneous bacterial peritonitis, Thoracentesis, thrombocytopenia, transexamic acid, Tube Thoracostomy, ultrasound-guided arterial lines, Ultrasound-Guided Central Line Insertion, Ultrasound-Guided Paracentesis, Ultrasound-guided radial artery line placement, Ultrasound-Guided Thoracentesis

More Tags – Arterial line placement, central line placement, chest tube placement, cirrhosis, DIC, featured, HPC updates, hyperfibrinolysis, paracentesis, thoracentesis, tube thoracostomy

This blog aims to summarize the data available on how to safely perform invasive hospital procedures in patients with cirrhosis. Unfortunately, no prospective randomized controlled trials have been conducted to inform the practice of procedural medicine in cirrhotic patients. Therefore,…

Safety of Thoracentesis and Tube Thoracostomy in Patients with Uncorrected Coagulopathies

Tube Thoracostomy Insertion

Tube Thoracostomy Insertion

Joseph Esherick, M.D., FAAFP, FHM

May 31, 2021

More Articles – Anticoagulants and Procedures, Anticoagulation, Antiplatelet therapy, antiplatelets, Chest tube, chest tube placement, chest tubes, coagulopathy, Featured, HPC Updates, Thoracentesis

More Tags – anticoagulation, antiplatelets, chest tube placement, coagulopathy, featured, HPC updates, thoracentesis, tube thoracostomy

Traditionally, it was felt that the INR had to be less than 1.5 and platelets had to be at least 50,000/µL to perform most bedside procedures. With more clinical evidence, we now know that low-risk bedside procedures can be performed…

Thoracentesis-Associated Pneumothorax is Rare when Performed by Procedural Experts Using Ultrasound Guidance

Thoracentesis Course

Thoracentesis Course

Joseph Esherick, M.D., FAAFP, FHM

May 31, 2021

More Articles – Featured Procedure, HPC Updates, Pneumothorax, Thoracentesis, Ultrasound-Guided Thoracentesis

More Tags – featured procedure, HPC updates, pneumothorax, thoracentesis, Ultrasound-guided thoracentesis

Original studies of ultrasound-guided thoracentesis concluded a 2% risk of pneumothorax. A recent single center study of 9320 thoracenteses over 12 years all by procedural experts had pneumothorax rate of 0.6%. This same study also demonstrated a very low incidence…