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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.