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Simplified Bedside Thoracentesis
- Bert Govig, MD; and
- Marc Baltzan, MD
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Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
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TO THE EDITOR:
Although thoracentesis is generally considered to be well tolerated and safe, variations in the thoracentesis catheter, the need for ultrasound guidance, and the experience required of the person doing the procedure have all been questioned [1-4]. In our search for a safer method of thoracentesis, we have begun doing diagnostic thoracentesis using a Vacutainer (Becton-Dickinson, Rutherford, New Jersey) blood-taking apparatus in a manner similar to that used in blood taking. The prepared skin is penetrated with the needle, and suction is applied while the needle is still in the soft tissue. The needle is then advanced into the pleural space. This technique is advantageous in that it uses equipment that is readily available and familiar to almost all physicians, and it costs less than one tenth of the price of commercially prepared thoracentesis kits. It also provides less exposure to body fluids because specimens are collected directly into the appropriate test tube.
We retrospectively reviewed 26 consecutive diagnostic thoracenteses done using this technique. The technique was successful in 25 of 26 cases and on the first attempt in 24. More than 65% of patients found the procedure to be less painful than venipuncture. No pneumothoraces were detected on postprocedure inspiratory and expiratory chest radiographs. This finding compares favorably with pneumothorax rates quoted in the literature (4% to 30% combined diagnostic and therapuetic [1-4]) and with 6 of 85 (7%) diagnostic thoracenteses retrospectively reviewed in our hospital (unpublished data). Admittedly, the size and design of our study preclude rigorous comparisons.
To our knowledge, this simplified technique has never been described in the medical literature. It should be included in future studies assessing the safety and diagnostic utility of thoracentesis.
Bert Govig, MD
Marc Baltzan, MD
Sir Mortimer B. Davis Jewish General Hospital; Montreal, Quebec J9T-252; Canada
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
- Copyright ©2004 by the American College of Physicians
