Ultrasound. PATIENT GUIDE and PREPARATION. Thoracentesis

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1 Ultrasound PATIENT GUIDE and PREPARATION Thoracentesis

2 What is a Thoracentesis? A Thoracentesis is a procedure that involves using a needle to drain fluid from either within the lungs or the surrounding pleural cavity (around your lungs). It is done using Ultrasound imaging (US) guidance. It can be done to determine the source of fluid buildup, to improve your recovery and quality of life, or for both reasons. How should I get ready for a Thoracentesis? At the time of referring you for a Thoracentesis your doctor should go over preparation with you. You will also be contacted by the Diagnostic Imaging booking office with further questions prior to booking the procedure. All patients must arrange with their doctor to get the following blood tests done 14 days prior to the procedure date: INR, PT, PTT, and Platelets. All patients on blood thinners must consult their doctor about stopping them before the procedure if possible. Recommended times to stop common blood thinners: Clopidogrel (Plavix), ASA (Aspirin) (7 days) Warfarin (Coumadin) (5 days) Heparin (6 hrs) Enoxaparin (Lovenox), Dalteparin (Fragmin), Dabigatran (Pradax), Rivaroxaban (Xarelto) (24 hrs) 2

3 Diabetics are not to take their insulin or Metformin the morning of the procedure. Please bring it with you to take after the exam as directed. Do not stop taking any medications without first consulting your doctor. If you have any questions about your medications please ask your doctor. All patients on blood thinners must arrange with their family doctor to have their INR, PT, PTT, and Platelets retested one day before the procedure. Tell your family doctor if you are allergic to freezing or any medications. Make sure to follow all preparation instructions carefully. If you do not follow all instructions the test will have to be rescheduled. Call the day surgery booking clerk the day prior to your test to confirm your appointment time at (902) between 12:30pm and 1:30pm. You must bring someone to the appointment with and have them drive you home after. If you do not bring someone, the procedure may not be done. You should have someone to stay with you for 24 hours after the test in case complications arise. You must have nothing to eat or drink 12 hours before your procedure. 3

4 When you arrive at the hospital register at Day Surgery. At Day Surgery a nurse will check and record your vitals and ask you some questions, before bringing you to Diagnostic Imaging. What can I Expect for my Thoracentesis? You will be asked to change into a hospital gown and brought into the US exam room. Before the procedure starts, the Radiologist (x-ray doctor) will go over the procedure with you and ask you to sign a consent form. This is a good time to ask any questions you may have. You will be sitting up for the entire procedure. You will be hooked up to a blood pressure monitor and pulse oximeter throughout the test. You may be given some conscious sedation medication through an I.V. to help relax you during the test and minimize the potential pain. An initial scan will be done to localize the fluid and the best way to access it. The radiologist will first clean off your skin with an antiseptic solution then inject local anesthetic (freezing that is similar to what a dentist uses) to numb the skin. 4

5 A needle will be inserted though your skin into the fluid under US guidance. Once proper placement is confirmed the radiologist will begin draining the fluid. The radiologist may take a sample of the fluid and send it to the laboratory for analysis by a pathologist. You may experience the urge to cough as the fluid is being drained, however it is critical you resist this urge as much as you can. After the fluid is drained, the needle will be removed and the insertion site will be dressed. A final scan may be done to check for remaining fluid. What can I Expect after my Thoracentesis. You may have an chest X-Ray taken immediately after. You will then be taken to Day Surgery for recovery and observation. Even though freezing was used, you may experience some pain at the drainage site as the freezing wears off. You may feel groggy from the sedation (if used), that will pass with time. 5

6 You may experience the urge to cough after the procedure, however it is best if you try and resist coughing as it can increase complications. If you begin to experience intense pain or shortness of breath, it is important you tell a nurse immediately. It is common to bring up some bloody sputum (split blood) after the procedure, this will be monitored by the nurses. Some people experience a feeling of pressure on the side where the fluid is drained after the procedure. You will be brought for a chest X-Ray 1-2 hours after the biopsy to check for complications. Depending on your recovery you will be discharged from Day Surgery usually about 4 hours after the procedure. What are the risks for my Thoracentesis? As with any procedure where the skin is punctured, there is a risk of infection. To minimize the chance of an infection your skin is cleaned with an antiseptic solution before the test (to kill potential germs) and all the instruments used will be sterile. Given the skin will be punctured, there is always a risk of bleeding during and after the biopsy. Any bleeding will be monitored closely before you can leave the hospital. 6

7 Since the fluid is taken from either within the lung, or just outside the lung, there is a chance of you developing a pneumothorax (collapsed lung). It is not uncommon for patients to develop a minor pneumothorax during or after the biopsy. If you were to develop a pneumothorax it would be monitored closely while you were within the hospital and you would not be discharged home until the radiologist felt it was safe for you to leave. How long will my Thoracentesis take? You need to register 1 hour prior to your appointment at the Day Surgery reception desk. The procedure itself will take approximately minutes. The observation and recovery time will take approximately 4 hours after the procedure finishes. NOTES: 7

8 The technologists are unable to give test results. Your doctor will receive a copy of the pathology report within approximately 1-2 weeks of the procedure. If you have any questions, concerns or if you are unable to keep your appointment, please do not hesitate to call the booking office at or toll free Diagnostic Imaging Department Yarmouth Regional Hospital 60 Vancouver Street Yarmouth, NS B5A 2P5 Patient Guides available on SWH promotes a smoke free and scent free environment. Prepared by Diagnostic Imaging Department, SWH. Revised July

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