US GUIDED CHEST DRAINAGE / ASPIRATION

Transcription

1 US GUIDED CHEST DRAINAGE / ASPIRATION Information Leaflet Your Health. Our Priority.

2 Page 2 of 6 Introduction This leaflet tells you about the procedure known as chest drain/aspiration. It explains what is involved and what the possible risks are. It is not meant to be a substitute for informed discussion between you and your doctor, but can act as a starting point for such a discussion. If you are having the chest drain/aspiration done as a pre-planned procedure, then you should have plenty of time to discuss the situation with your consultant and the Radiologist who will be doing the aspiration, and perhaps even your own GP. If you need the procedure done as a relative emergency, then there may be less time for discussion, but none the less you should have had sufficient explanation before you sign the consent form. Do make sure that you have had enough information before you sign the consent form. What is a chest drain? A chest drain is a narrow tube that is inserted and sits in the space between the lung and the chest wall. This space is lined on both sides by a membrane called the pleura and is known as the pleural cavity or pleural space. Why do I need a chest drain/aspiration? Other tests that you probably have had performed, such as an x-ray, ultrasound scan or a CT scan, will have shown that there is some fluid (pleural effusion) or pus (empyema) accumulated in the pleural space. Any of these can cause problems with breathing and can stop the lungs from working properly. The chest drain will allow the fluid or pus to leave the body and improve your breathing. If there is only a small amount of fluid accumulated in the pleural space a drain may not be necessary but the doctor might want to take a fluid sample (aspirate) with a thin needle so it can be analyzed in the laboratory. Who has made the decision? The Consultant in charge of your case and the Radiologist doing the procedure, have discussed the situation, and feel that this is the best thing to do. However, you will also have the opportunity for your opinion to be considered. If after discussion with your doctor you don t want the procedure carried out, then you can decide against it. Who will be doing the drainage/aspiration? A specialist trained doctor called Radiologist. Radiologists have special expertise in using ultrasound and scanning equipment, and also in interpreting the images produced. They need to look at these images while carrying out the procedure. Where will the procedure take place? Generally in the x-ray department, in a special screening room, which is adapted for specialised procedures.

3 Page 3 of 6 How do I prepare for a chest drain/aspiration? If you are only having an aspiration of your chest, the procedure can sometimes be done as an outpatient. If you are having a chest drain inserted you need to be an in-patient in the hospital. You should not eat or drink for six hours before the procedure. If you are diabetic special arrangements should be made by your consultant as it may be difficult for you to starve for that length of time You need to have some blood taken before the procedure. You can take your regular medication with small sips of water but no solid food. If you are taking any of the following oral anticoagulants: - Clopidogrel, Warfarin, Apixaban, Rivaroxaban, Dabigatran or Sinthrome, these will need to be stopped prior to the procedure. If no arrangement has been made with you to do this, please contact the Department on If you have any allergies you must let your doctor know. What actually happens during a chest drainage/aspiration? You will be welcomed into the interventional room and introduced to the nurses and the Radiologist who will be doing the procedure. The Radiologist will explain the procedure to you, how it will be performed and the risks involved. The Radiologist will then ask your permission to do the drainage/aspiration by asking you to sign the consent form. This may have already been done by your Consultant in chest clinic a few days before the procedure or on the ward before you get transferred to the x-ray department. You will be asked to sit down on the ultrasound table. Depending on the approach used by the radiologist you will be asked to lie on your back, on your front, on your side or remain seated. The radiology nurse throughout the procedure will monitor your blood pressure, heart rate and oxygen saturation levels. The Radiologist will inject local anaesthetic into the skin and deeper tissues. This will numb the area so you should not feel anything. The Radiologist will then use the ultrasound probe to guide the needle into the right place. If you are having an aspiration the Radiologist will take a small amount of fluid and will send it to the laboratory for analysis. When the procedure is finished the Radiologist will apply a dry dressing to your skin. If you are having a drain put in, the Radiologist will use the ultrasound probe to guide the drain into the pleural space. The drain tube is then covered with a bag that is attached to you skin. The fluid in the pleural space will drain into this bag for the next hours. After this period of time the drain can be removed. What happens afterwards? You will be taken back to your ward on a trolley. Nurses on the ward will carry out routine observations, such as taking your pulse and blood pressure, to make sure that there are no problems. It is important that you rest in bed after the procedure to minimize the risk of complications. Occasionally a chest x-ray is needed after the procedure to check your lungs for any complications.

4 Page 4 of 6 Will it hurt? Most patients undergoing chest drain/aspiration do not complaint of any pain. When the local anesthetic is injected, it may sting to start with, but this soon passes off, and the skin and deeper tissues should then feel numb. Later, you may be aware of some pressure, but the procedure is generally done so quickly, that it does not cause any discomfort at all. There will be a nurse, or another member of clinical staff, standing next to you and looking after you. If the procedure does become painful for you, please let them know. How long will it take? Every patient s situation is different, and it is not easy to predict how complex or how straightforward the procedure will be. It may be over in 10 minutes or it may take longer than 30 minutes. As a guide, expect to be in the x-ray department for about 45 minutes. Are there any risks or complications? Chest drain/aspiration is a very safe procedure, but there are a few risks or complications that can arise, as with any medical treatment such as pain, bleeding or infection. Sometimes air can get into the space around the lung (pneumothorax). This generally does not cause any real problem, but if it causes the lung to collapse, then the air will need to be drained, either with a needle, or else with a small tube, put in through the skin. If this were to occur you may need to stay in hospital for a few days to treat the pneumothorax. Despite these possible complications, chest drain/aspiration is normally very safe, and is designed to save you from having a bigger procedure. What are the benefits of a chest drain/aspiration? The chest drain will allow the fluid or pus to leave the body and improve your breathing. The results of the samples analyzed in the laboratory will give your doctor valuable information about your condition. This information will enable your doctor to provide you with the most appropriate treatment. Are there any alternatives? The fluid in the pleural space could alternatively be removed using keyhole surgery. Keyhole surgery usually requires an overnight stay in hospital and a general anaesthetic so is therefore a slightly higher risk procedure. Finally Some of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion about your treatment with the doctors looking after you. Do satisfy yourself that you have received enough information about the procedure before you sign the consent form.

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6 Page 6 of 6 If you would like this leaflet in a different format, for example, in large print, or on audiotape, or for people with learning disabilities, please contact: Patient and Customer Services, Poplar Suite, Stepping Hill Hospital. Tel: Information Leaflet. PCS@stockport.nhs.uk. Our smoke free policy Smoking is not allowed anywhere on our sites. Please read our leaflet 'Policy on Smoke Free NHS Premises' to find out more. Leaflet number RAD85 Publication date October 2013 Review date October 2015 Department X-Ray B Location Stepping Hill Hospital