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Table 64.3

Needle Aspiration of Pneumothorax

  1. Identify the 2nd or 3rd intercostal space in the mid-clavicular line.
  2. Infiltrate with lidocaine down to and around the pleura.
  3. Connect a 21 G (green) needle to a three-way tap and a 60 mL syringe.
  4. With the patient semi-recumbent, insert the needle into the pleural space. Withdraw air and expel it via the three-way tap.
  5. Aspirate up to a maximum of 2.5 L.
  6. Obtain a chest X-ray to assess resolution of the pneumothorax.
  7. If aspiration fails to sufficiently re-inflate the lung, insert small bore (<14F) chest drain (Chapter 122).