9/6/2023 0 Comments Tap walkthrough form![]() ![]() Any immediate post-procedure concerns or complications.Volume and colour of ascitic fluid aspirated.An ultrasound scan may be required (if not already performed) to confirm the presence of ascites and mark the ideal needle insertion point.Įxplain to the patient that the procedure is now complete.ĭocument the patient’s details on the specimen containers at the bedside (using either pre-printed or handwritten labels).ĭispose of PPE and other clinical waste into an appropriate clinical waste bin.ĭocument the details of the procedure including: Seek senior advice if you are unable to aspirate ascitic fluid. Place the aspirated ascitic fluid into appropriate specimen containers. Withdraw the needle, disconnect it from the syringe and dispose of the needle in a sharps bin. ![]() ![]() The Z track technique for performing an ascitic tap Removal of the needle This technique creates a non-linear path between the skin and abdominal cavity. The skin is then released after the needle has been removed. The skin is held in this position whilst the needle is advanced. The skin is stretched approximately 2cm before inserting the needle into the epidermis. The Z-track technique is an alternative technique which can be used to reduce leakage of ascitic fluid following paracentesis. Holding the needle perpendicular to the skin, insert the needle into the previously identified location on the patient’s abdomen.Īdvance the needle slowly, ensuring you aspirate as you advance.Īdvance and aspirate until ascitic fluid is aspirated into the syringe. Collect a sample of ascitic fluidĪttach a 19G green needle to a 20ml syringe. Replace the 25G orange needle with a 19G green needle.Īdminister lidocaine deeper into the tissue, aspirating as you go until you get a flashback of ascitic fluid. Aspirate to ensure you are not in a blood vessel. If the patient wishes to have local anaesthetic, prepare and administer lidocaine subcutaneously using an orange needle (25G) over the planned puncture site (create a bleb). Perform the ascitic tap Local anaesthetic Wash your hands and don sterile gloves and an apron.Ĭlean the insertion site and the surrounding area thoroughly using chlorhexidine solution and allow it to dry. Remove equipment from its packaging and place it onto a sterile surface so that it is easily accessible during the procedure. If available: use ultrasound to assess the location of ascites further and to find the ideal location for needle insertion. Gain consent to proceed with an ascitic tap.Ĭheck if the patient has an allergy to local anaesthetic (if requested) or to the skin preparation agent.Īsk the patient if they have any pain before continuing with the clinical procedure. ![]() There are a few risks associated with this procedure, these include infection, pain bleeding, and very rarely damage to the surrounding structures in your abdomen.” I can administer some local anaesthetic to the area which will reduce the pain when I take the sample. It may be a little painful, however, it should not take long. This procedure involves me inserting a needle into your abdomen. It will be tested in the lab to find out the cause and whether the fluid is infected. Introduce yourself to the patient including your name and role.Ĭonfirm the patient’s name and date of birth.Įxplain what the procedure will involve using patient-friendly language: “ I need to take a sample of fluid from your abdomen. If your hands are visibly soiled, wash them with soap and water. However, it is possible to perform this procedure without ultrasound. Ideally, ultrasound is used to confirm the presence of ascites and identify a suitable needle insertion site. If local anaesthetic is being used, additional equipment includes: In an OSCE setting, local anaesthetic should always be offered for an ascitic tap. Some patients may opt not to have local anaesthetic administered as this involves fewer needles. Using local anaesthetic when performing an ascitic tap depends on patient choice. Specimen container (usually a white top specimen pot).Sterile surface (nursing trolley which has been appropriately cleaned).Gather the appropriate equipment to perform an ascitic tap: If you’d like to learn about inserting an ascitic drain, check out our dedicated guide. If you’d like to learn more about interpreting ascitic fluid results then check out our ascitic fluid analysis guide. Download the ascitic tap (diagnostic paracentesis) PDF OSCE checklist, or use our interactive OSCE checklist. ![]()
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