Paediatrics: Pericardiocentesis

2021-03-05 12:00 AM

Therapeutic drainage of pericardial effusion or for diagnostic purposes.

Pericardiocentesis

Indications

Therapeutic drainage of pericardial effusion or for diagnostic purposes.

Equipment

  • Alcohol impregnated swab/antiseptic solution, e.g. 0.5% chlorhexidine.
  • 21G needle or IV cannula and 10–20mL syringe.
  • Sterile gloves, drapes, gown, and adhesive plaster.
  • Sterile sample containers if pericardial fluid analysis intended.

Procedure

  • Lay child on a 30° slope to cause effusion to pool inferiorly.
  • Locate the insertion site; this lies just below the angle between the sternum and the left costal margin.
  • Use sterile gloves and gown. Clean the site with antiseptic and place sterile drapes around the insertion site.
  • Local anaesthetic infiltration may be appropriate.
  • Insert needle connected to syringe at an angle of 30° to the skin and advance slowly, aiming towards the left shoulder. Gently aspirate the syringe as the needle is inserted.
  • Stop when pericardial fluid (usually straw-coloured) is aspirated and remove the desired amount as indicated.
  • Once drainage is complete, remove the needle and apply adhesive plaster.