Procedures Flashcards
ICC insertion
Indications:
>25% pneumothorax, empyema, haemothorax, malignant effusion (before chemo/sclerosing agent), lobulated empyema (insert fibronolytic agent)
Contraindications:
Previous pleurodesis
Bleeding diathesis - relative
Local infection - relative
Anatomy:
Go over rib, aim for 5th or 6th intercostal space around mid axillary line
Equipment:
Sterile gown, gloves, drape, skin prep
Assistant
LA, Sedative drugs
Continuous monitoring (pulse oximetry)
ICC of appropriate size 24-28 for air, 28-32 for fluid
Petroleum jelly gauze dressing
Wide impermeable tape
Underwater drain
Suction device
1-0 or 0 silk suture
Prior to procedure:
Airway and emergency resuscitation equipment available
Gain informed consent
Consider sedation if patient haemodynamically stable and awake
Sitting up 30-60 degrees, pillow under side that ICC going to be inserted into
Have arm abducted and externally rotated
Confirm and mark site before scrubbing and prepping put an X
NGT
remove guide wire after CXR
