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HDU SOP Pleurodesis
HDU SOP Pleurodesis
Pleurodesis
Equipment list
50 ml syringe
2 x 10cc Syringes
Procedure:
1. Explain and discuss the procedure to the patient and take consent.
2. Record baseline observations of temperature, pulse, respiratory rate and
oxygen saturations.
3. Pre-medicate with Inj Diazepam/Opioid if required. Give it time to
become effective.
4. Prepare Talc Slurry (if not already prepared by pharmacy) by dissolving
3-5g of talc in 50ml of Normal Saline.
5. Clamp the chest tube, open its junction with underwater seal.
6. Give Inj Lignocaine 2% about 10ml (200mg) not more than 250mg
through 50ml Feeding syringe into the chest tube, diluted in about 10 –
20 ml if Normal Saline. Wait for about 10 min for anesthetic to take
effect.
7. Administer Talc Slurry through the chest tube using the feeding syringe.
An additional 20 – 25 ml of Normal Saline may be given to flush the
slurry into the pleural cavity.
8. Elevate the tube higher than the wound, and clamp it again.
9. After one hour, unclamp the tube and allow free drainage of fluid through
the underwater seal. Tube may be flushed or suctioned to ensure fluid is
draining.
10. If draining volume is less than 150ml in next 24 to 48 hours, extubate. If
>250ml, consider repeat pleurodesis.
11. Get a fresh X-Ray Chest to confirm apposition of Pleural surfaces.
Precautions: