Abdominal paracentesis
This is indicated for drainage of
ascites when it compromises breathing, e.g. hydrops fetalis, or for diagnostic
purposes, e.g. following trauma.
As for, Pericardiocentesis.
•
In
infants, the left iliac fossa is the preferred site (which avoids liver and
spleen). In older children, a midline site between the symphysis pubis and the
umbilicus is preferred because of less vascularity.
•
Lay
the child supine. If ascites is minimal also tilt towards the left side.
•
Except
in emergencies, clean and prepare the site as described Pericardiocentesis.
•
Attach
needle to the syringe and carefully insert it at 90° to the skin.
•
Aspirate
fluid and place it in sample containers. If large amounts of fluid are to be
drained use an IV cannula. Once inserted, remove the stylet, and leave the
cannula in place to reduce the risk of bowel perforation. If prolonged drainage
is needed, attach the cannula to the skin using adhesive tape or stitches.
•
Once
complete, remove needle and apply sterile plaster to site
•
If a
large amount of fluid is withdrawn, drainage should be followed by IV infusion
of albumin.
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