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Pericardiocentesis OVERVIEW OF TECHNIQUES AND EQUIPMENT If the patient is able to cooperate, elevate the chest 30 to 45 degrees to bring the heart closer to the chest wall If the patient is awake, anesthetize the skin and the proposed route with 1% lidocaine Because the pericardium is extremely sensitive, it should be anesthetized * Invasive procedures in cancer patient * Pericardiocentesis OVERVIEW OF TECHNIQUES AND EQUIPMENT Subxiphoid/Subcostal Approach: Introduce the needle 1 cm inferior to the left xiphocostal angle at a 30-degree angle to the skin Aim toward the left shoulder Recommendations regarding needle trajectory vary widely, including toward the right shoulder, sternal notch, and left shoulder * Invasive procedures in cancer patient * Pericardiocentesis OVERVIEW OF TECHNIQUES AND EQUIPMENT Apical Approach: If the apex cannot be palpated, it typically lies within the area of cardiac dullness, often between the fifth, sixth, or seventh intercostal space, between the midclavicular and midaxillary lines. Introduce the needle 1 cm lateral to and into the intercostal space below the apical heartbeat. Advance the needle over the cephalad border of the rib and aim it toward the right shoulder * Invasive procedures in cancer patient * Pericardiocentesis OVERVIEW OF TECHNIQUES AND EQUIPMENT Parasternal Approach: Introducing the needle 1 cm lateral to the sternal border at the left fifth or sixth intercostal interspace. * Invasive procedures in cancer patient * * Invasive procedures in cancer patient * * Invasive procedures in cancer patient * Invasive procedures in cancer patient Invasive procedures in cancer patient Invasive procedure in cancer patient DR. Alireza Abootalebi Assistant Professor Of Emergency Medicine Isfahan Univercity Of Medical Science IN THE NAME OF GOD * Invasive procedures in cancer patient * Thoracentesis Thoracentesis DIAGNOSIS OF PLEURAL EFFUSION Clinical Diagnosis: The three most common symptoms related to pleural effusions are
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