Scribd Logo
Upload

Welcome to Scribd!

  • 129 views

    PP Dokter Setia Putra Tarigan MASSIVE PLEURAL EFFUSIONS BPLS Maret 2015

    Uploaded by

    zhafran ritonga
    This document provides information about basic pulmonary life support (BPLS) and the treatment of pleural effusions. It defines a massive pleural effusion as an accumulation of fluid that opacifies the entire hemithorax and shifts the mediastinum. Symptoms include dyspnea. Treatment involves thoracentesis, which is the insertion of a needle into the pleural space to drain fluid. The procedure requires local anesthesia and sterile technique. Up to 1.5 liters of fluid can be drained before stopping. As massive pleural effusion only indicates a problem but not a diagnosis, further evaluation by a pulmonologist is needed after thoracentesis.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd

    PP Dokter Setia Putra Tarigan MASSIVE PLEURAL EFFUSIONS BPLS Maret 2015

    Uploaded by

    zhafran ritonga
    129 views19 pages
    This document provides information about basic pulmonary life support (BPLS) and the treatment of pleural effusions. It defines a massive pleural effusion as an accumulation of fluid that opacifies the entire hemithorax and shifts the mediastinum. Symptoms include dyspnea. Treatment involves thoracentesis, which is the insertion of a needle into the pleural space to drain fluid. The procedure requires local anesthesia and sterile technique. Up to 1.5 liters of fluid can be drained before stopping. As massive pleural effusion only indicates a problem but not a diagnosis, further evaluation by a pulmonologist is needed after thoracentesis.

    Original Title

    7. PP dokter setia putra tarigan MASSIVE PLEURAL EFFUSIONS BPLS Maret 2015.ppt

    Copyright

    © © All Rights Reserved

    Available Formats

    PPT, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document provides information about basic pulmonary life support (BPLS) and the treatment of pleural effusions. It defines a massive pleural effusion as an accumulation of fluid that opacifies the entire hemithorax and shifts the mediastinum. Symptoms include dyspnea. Treatment involves thoracentesis, which is the insertion of a needle into the pleural space to drain fluid. The procedure requires local anesthesia and sterile technique. Up to 1.5 liters of fluid can be drained before stopping. As massive pleural effusion only indicates a problem but not a diagnosis, further evaluation by a pulmonologist is needed after thoracentesis.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    129 views19 pages

    PP Dokter Setia Putra Tarigan MASSIVE PLEURAL EFFUSIONS BPLS Maret 2015

    Uploaded by

    zhafran ritonga
    This document provides information about basic pulmonary life support (BPLS) and the treatment of pleural effusions. It defines a massive pleural effusion as an accumulation of fluid that opacifies the entire hemithorax and shifts the mediastinum. Symptoms include dyspnea. Treatment involves thoracentesis, which is the insertion of a needle into the pleural space to drain fluid. The procedure requires local anesthesia and sterile technique. Up to 1.5 liters of fluid can be drained before stopping. As massive pleural effusion only indicates a problem but not a diagnosis, further evaluation by a pulmonologist is needed after thoracentesis.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 19

    BASIC PULMONARY LIFE SUPPORT

    BPLS - 2015

    dr. Setia Putra Tarigan, Sp.P (K)


    Department of Pulmonology and Respiratory Medicine
    Faculty of Medicine University of Sumatera Utara
    Adam Malik General Hospital
    Medan
     Pleural effusions is an accumulation of pleural
    fluid in the pleural space

     Massive pleural effusion:


     Pleural effusion with opacification on entire
    hemithorax
     Mediastinum is shifted toward the contralateral side
     Dyspnea
     Reduction in lung volumes
     Ventricular filling may be
    impeded leading to decreased
    cardiac out put
    SYMPTOMS PHYSICAL EXAM

     Dyspnea  I: Discrepancy in size of


     Pleuritic chest pain hemithorax
     Non-productive cough  P: Decreased tactile
    fremitus
     P: Dullness to
    percussion
     A: Decreased breath
    sounds
    Minimal free pleural effusion Moderate free pleural
    effusion

    Large free pleural effusion Massive pleural effusion


     Thoracocentesis terapeutic

     Chest tube insertion


     = THORACENTESIS
     = PLEURAL ASPIRATION
     = PLEURAL TAPPING
     Ensure documented
    consent is obtained
    (encompass common and
    serious complications)
     Complications:
    pneumothorax, procedure
    fail, pain, haemorrhage,
    visceral injury.
     Patient position and site of
    insertion: the preferred
    site for insertion of the
    needle should be the
    triangle safety
     Equipment:
     Skin sterilising fluid: alkohol 70% and povidone
    iodine
     A clean dressing
     A 10 ml syringe
     A 50 ml syringe
     A three-way tap
     Intravenous cannula/abbocath 14
     Tubing/syringe
     Lidocaine 2%
     Sterile gloves
     Procedure:
    1. Local anaesthetic is infiltrated into the site of
    thoracocentesis
    2. A 10 ml syringe is used to raise a dermal bleb before
    deeper infiltration of the intercostal muscles and
    pleural surface (a spinal needle may be required in the
    presence of a thick chest wall)
    3. Local anaesthetic such as lidocaine (up to 3 mg/kg)
    is usually infiltrated. Higher doses may result in
    toxic levels
    4. The pleural space should be aspirated with the
    needle used to administer the local anaesthetic
     Procedure (continued…)
    5. The aspiration needle or cannula/abbocath 14
    should then be advanced into the chest, aspirating
    continually until the pleura is breached and fluid are
    withdrawn
    6. The cannula/abbocath 14 should then be attached to
    a three-way tap and fluid withdrawn into the syringe
    and expelled via the free port of the three-way tap into
    a bag or jug for fluid
    7. This process should be repeated and continued until
    the procedure is terminated.
    8. The cannula/abbocath 14 is then removed and
    simple dressing applied
     The procedure should be stopped
     When no more fluid can be aspirated
     The patient develops symptoms of cough or chest
    discomfort, or
     1.5 l has been withdrawn
     Because massive pleural effusion is a sign of
    disease and not a diagnosis in itself, after
    therapeutic thoracocentesis  the patient
    should be referred to the pulmonologist for
    further management.
     http://www.nejm.org/doi/full/10.1056/NEJMvc
    m053812
    JUAH

    You might also like