Draining Fluids: Hospital Methods And Techniques

There are various reasons why fluid can build up in the body, including infection, injury, organ damage, and cancer. Fluid retention, or edema, occurs when the body is unable to maintain fluid levels due to problems with the circulatory system, kidneys, lymphatic system, or other bodily systems. Hospitals employ different procedures to remove excess fluid from the body, including paracentesis, thoracentesis, and fluid aspiration and drainage. Paracentesis involves inserting a needle and catheter to drain fluid buildup in the abdomen, while thoracentesis removes fluid from the chest using a chest tube or a smaller drain. Fluid aspiration and drainage involve inserting a needle into the fluid pocket to collect a sample for testing or to drain the fluid. These procedures are generally safe and effective in relieving symptoms and diagnosing the underlying cause of fluid buildup.

Paracentesis: a procedure to remove fluid buildup in the abdomen

Fluid can build up inside the body due to various reasons, such as infections, cancer, injuries, or organ damage. Paracentesis is a procedure that removes this excess fluid buildup, specifically from the abdomen, where it is called ascites. This procedure can be performed in a hospital or a provider's office and can be life-saving in certain circumstances.

Before the procedure, the patient may be asked to empty their bladder. The patient is then positioned on their back, with the bed either flat or slightly raised to elevate the head. The area where the needle will be inserted is cleaned and numbed with a local anesthetic to prevent pain. An ultrasound device is commonly used to identify the fluid buildup and determine the exact insertion point for the needle.

During paracentesis, a needle and a catheter are used to drain the excess fluid. The needle is inserted into the numbed area, and a plastic catheter tube is placed at the site to facilitate fluid drainage. The fluid may be collected in a syringe or a vacuum-powered container.

Paracentesis not only relieves symptoms of ascites but also aids in diagnosing the underlying cause. By analyzing the drained fluid, healthcare providers can determine whether the buildup is related to cancer, infection, organ injury, or other common causes. Depending on the patient's condition, a single paracentesis procedure may be sufficient to eliminate the ascites.

Thoracentesis: a procedure to remove fluid from the chest

Thoracentesis is a safe, minimally invasive procedure to remove fluid from the chest, usually taking around 15 minutes. It is often performed to relieve symptoms of pleural effusion, which is excess fluid in the space between the lungs and the chest wall. This excess fluid can cause difficulty breathing, coughing, chest pain, and weakness.

Before the procedure, your healthcare provider will take your blood pressure and measure your blood oxygen level. Imaging techniques such as X-rays, ultrasounds, or CT scans will be used to locate the fluid and determine its amount. You will be asked to change into a gown, remove any jewellery, and sit with your arms resting on a table. If you are unable to sit, you can lie on your side.

During thoracentesis, a chest tube or a smaller drain with a curled end (known as a pigtail catheter) is inserted into the chest by a surgeon, pulmonologist, or radiologist. This tube stays inside the chest for a few days to drain fluid or air. The procedure is not considered major surgery, and the recovery time is short with lower risks compared to more invasive procedures.

While thoracentesis is generally safe, there are some potential complications to be aware of. These include minor bleeding, infection due to the skin break, a collapsed lung (pneumothorax), and pulmonary edema if the fluid is removed too quickly. Your healthcare provider will explain the specific risks and ensure that the fluid is located with imaging before the procedure to minimise these risks.

Fluid aspiration: removing fluid with a needle and syringe

Fluid aspiration is a procedure to remove fluid from the body using a needle and syringe. This procedure is often carried out to remove fluid from the space around a joint, relieving swelling and pain and improving movement. It is also performed to obtain fluid for analysis to help diagnose joint disorders or problems. Fluid aspiration is usually performed on the knee joint, but it can also be done on other joints such as the hip, ankle, shoulder, elbow, and wrist.

During the procedure, the patient may be asked to remove clothing and will be given a medical gown to wear. The skin over the joint will be cleaned with an antiseptic solution to prevent infection. If a local anaesthetic is administered, the patient will feel a needle prick when it is injected, causing a brief sharp sting. The doctor will then insert a needle through the skin into the joint. The patient may feel some discomfort or pressure at this point.

The doctor will then attach a syringe to the needle and remove the fluid by drawing it into the syringe. The amount of fluid removed is typically small, and if a larger amount needs to be extracted or the fluid is too thick, drainage may be recommended instead. After the fluid is removed, the needle will be taken out, and a sterile bandage or dressing will be applied to the site.

Following the procedure, the patient may experience mild discomfort or pain at the site of fluid removal. The healing process usually takes a few days. The fluid may be sent for testing, and medication may be injected into the joint to treat conditions such as tendonitis or bursitis. It is important to discuss any concerns or risks with the healthcare provider before the procedure and to provide information about any medical problems or allergies.

Drainage: removing fluid with a thin plastic tube

Drainage is a procedure to remove excess fluid from the body using a thin plastic tube. This procedure is often carried out while the patient is still in hospital, although it can be performed post-discharge as well. The patient is usually a child, and the procedure is carried out under general anaesthesia. The doctor uses imaging techniques such as ultrasound, X-rays, and occasionally, a CT scan to guide them. Local anaesthesia is injected into the skin to numb the area for a few hours.

Once the position is confirmed, a small incision is made through the skin, and the thin plastic drainage tube is inserted. The free end of the tube is connected to a drainage bag that collects the fluid. The incision is then closed with a stitch to hold the tube in place, and the area is covered with a large dressing. The drainage bag is changed as needed by the nurses. Ultrasound scans or X-rays are used to check the amount of fluid left in the body. When most of the fluid has drained, the tube is removed. This is done on the ward and is not painful. The child may be offered a mixture of gas and air to deal with any discomfort. The nurses will cover the incision with a dressing, and the child will be able to go home. The dressing must be kept dry for the next two days.

The Jackson-Pratt (JP) drain is a type of closed-suction drain used to draw out excess fluid from a wound following surgery. It is a thin, flexible tube with a squeezable, lemon-shaped bulb at the end that collects wound drainage. The JP drain moves the fluid from the wound to the bulb outside the body. Removing the fluid helps the wound heal faster and may reduce the risk of infection. The JP drain uses suction to gradually draw out the fluid. It has a flattened end with holes that go inside the wound, allowing the fluid to seep in.

Ultrasound scans: used to check the amount of fluid in the body

Ultrasound scans are a safe, effective, and non-invasive way to check the amount of fluid in the body. Ultrasound imaging uses sound waves to create pictures of organs, tissues, and other structures inside the body. This allows doctors to see inside a patient's body without surgery. Ultrasound scans are often used to check the amount of amniotic fluid during pregnancy, but they can also detect fluid in other parts of the body.

Ultrasound scans are typically carried out by a sonographer, a healthcare professional with special training in ultrasound exams. The sonographer will apply a small amount of water-soluble gel to the patient's skin over the area being examined. This gel helps the sound waves travel between the transducer (a small handheld device) and the body. The gel does not stain clothes or harm the skin.

The transducer sends out inaudible, high-frequency sound waves into the body and records the returning echo waves. As the sound waves bounce off internal organs, fluids, and tissues, the transducer records tiny changes in the sound's pitch and direction. A computer then uses this information to create real-time images, which can be viewed on a monitor.

Ultrasound scans can be used to detect abnormal masses, such as cysts or tumours, and to guide procedures such as fluid aspiration and needle biopsies. In the case of fluid aspiration, the ultrasound allows the doctor to see the internal organs and guide the needle to the correct place to drain the fluid. Ultrasound is often preferred over other imaging techniques, such as X-rays, as it does not use radiation and can provide real-time imaging.

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