Thoracentesis At The Bedside: Procedure, Risks, Benefits, And Team Roles Explained

In inpatient and outpatient care, healthcare professionals encounter patients with varying needs. Regardless of the situation, accurate diagnosis and treatment are critical. Jane Anderson is a 58-year old African American who has been in and out of Mercy Medical Center due to congestive heart failure. She was also recently diagnosed with abdominal infections. Lately, her conditions have worsened, and she presents herself with chest pain, rapid breathing, shortness of breath, and intense fever. Since the signs and symptoms differ from what she usually experiences, nurses refer her for advanced tests for pleural effusion. Two tests, a chest CT scan and magnetic resonance imaging (MRI) scan, confirm pleural effusion. Jane’s personal physician recommends an immediate thoracentesis to remove the pleural fluid. The purpose of this paper is to describe how thoracentesis at the bedside works, its risks and benefits, and the interdisciplinary team’s roles and responsibilities. It will also describe nurses’ knowledge and skills required to provide care and patient education considerations.

Explanation and Background

Breathing problems and chest pains make patients uncomfortable and care provision challenging. The situation is more challenging for patients with pleural effusion co-occurring with other conditions like Jane Anderson. Wiederhold et al. (2021) described thoracentesis as a minimally invasive procedure for diagnosing and treating pleural effusions. To diagnose pleural effusions, the procedure helps determine the cause to guide further treatment. Removing the fluid or the air eases pain and breathing complications (Wiederhold et al., 2021). When performing thoracentesis, the responsible health care professional inserts a needle through the chest wall into the pleural space, the area with a small amount of fluid. The presence of excess fluid is the genesis of breathing problems since it prevents the pleura from rubbing together. The lungs cannot inflate completely, implying shortness of breath, discomfort, pain, and other complications due to limited physical activity.

Regarding the patient population, thoracentesis is typically for patients requiring inpatient care. They include adults with congestive heart failure (CHF), tuberculosis, pneumonia, and pulmonary embolism. Medications recommended after the procedure are primarily for easing pain and preventing pneumothorax, the commonest complication after thoracentesis (Shechtman et al., 2020). Safety should be a priority to prevent complications and exposure to other infections and injuries. Patients are advised to avoid intensive physical activities and habits that complicate breathing, such as smoking. Cost considerations include the expensive nature of the procedure since it can go as high as $1,500. Despite the challenges and excessive caution, the treatment modality is effective overall.

Risks and Benefits

Many treatment modalities for critical body organs are risky, particularly when they alter human functionality after a procedure. In most cases, procedures associated with skin penetration involve some infection risks. As a result, many patients require antibiotics after thoracentesis. Shechtman et al. (2020) found that partial collapse of the lungs (pneumothorax) is common after air enters the pleural space. Other risks include breathing problems and bleeding. Safety should be prioritized since removing too much fluid rapidly can cause pulmonary edema. Such risks increase morbidity, mortality, and overall health care cost. A suitable example of the effects of the risks is extended hospital stays due to iatrogenic pneumothorax (up to 4 days), increasing costs significantly (Hallifax et al., 2020). Caution at all levels is necessary.

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Health care professionals propose a treatment modality based on its effectiveness. Thoracentesis has many benefits. Firstly, it is not a complex process; a patient can go through it and go home the same day. Secondly, thoracentesis is safe; morbidity and mortality chances are extremely low (Shechtman et al., 2020). Thirdly, thoracentesis helps to relieve pain and pressure on vital organs such as the lungs and treat breathing complications. The other crucial benefit of the procedure is helping health care professionals to determine the cause of pleural fluid to guide evidence-based interventions.

Interdisciplinary Team’s Roles and Responsibilities

Thoracentesis at the bedside requires teamwork, active communication, and an in-depth understanding of patient needs. Th