pleura. This is usually small and does not
produce symptoms. Larger pneumothoraces
require prompt therapy. The risk of puncturing
the visceral pleura is minimized by avoiding
those portions of the chest where pleural
adhesions are known to exist and by advancing
the needle and the trocar less than 1 cm beyond
the parietal pleura.
2. Subcutaneous emphysema caused by the needle
track is avoided by sealing the puncture site
immediately after withdrawing the needle.
3. Hemorrhage into the intercostal space and the
pleural cavity will occur if the intercostal
vessels, especially the artery, are punctured.
Significant acute blood loss and hemothorax can
result. This complication is rare if the needle
and the trocar are kept just above the lower rib
as they are advanced through the intercostal
space.
4. Puncture of the diaphragm and subdiaphragmatic
organs is avoided by selecting the puncture site
carefully. The site should not be below the ninth
rib posteriorly or the seventh rib laterally.
Specimen Collection Procedures A-13
