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{{Authors|author1=[[User:Mikael Häggström|Mikael Häggström]]|author2=}}
==Planning==
===Choice of procedure===
Pigtail catheter insertion is an effective and safe method of draining pleural fluid. It is encouraged for use in all cases of pleural effusion requiring chest drain except for empyema and other loculated pleural effusions, where it has low success rates.<ref name="BediwyAmer2012">{{cite journal|last1=Bediwy|first1=Adel Salah|last2=Amer|first2=Hesham Galal|title=Pigtail Catheter Use for Draining Pleural Effusions of Various Etiologies|journal=ISRN Pulmonology|volume=2012|year=2012|pages=1–6|issn=2090-5777|doi=10.5402/2012/143295}} [http://creativecommons.org/licenses/by/3.0/ CC-BY license]</ref>
{{Low risk of bleeding}}
==Technique==
This is an example used in Swedish practice, in this case without use of Seldinger technique:<ref>{{NU Hospital Group}}</ref>
#Ask for any allergic reaction to local anesthetics
#Check proper puncture location with ultrasonography. Strive to puncture close to the inferior rib border rather than the superior one, to avoid damage to intercostal nerves and vessels. The direction of the catheter should usually be toward the basal-dorsal parts. The puncture location can be marked by a skin impression (such as a pen with withdrawn nib), or with a skin marker (which may, however, disappear during washing).
#The skin area is washed with an antiseptic
#Wear at least sterile gloves, and use sterile coverage on the ultrasound probe
#Preferably use a pigtail catheter, such as French gauge 10, and fixate a cannula inside it
#Have a scalpel ready for skin incision
#Infuse local anesthetic, such as 10 - 20 ml of 1% carbocaine, both superficially, at the rib above and below, and by the pleura
#Make a skin incision large enough for the catheter to pass
#Under ultrasound guidance, insert the catheter with the cannula until reaching within the pleural space.
#Loosen the cannula from the catheter, and advance the catheter only, generally in dorsal-basal direction.
#Withdraw the cannula
#Check for return. Attach plug or syringe to the external tip.
#Fix the pigtail of the catheter
#Fixate the external part to the skin
==References==
{{reflist}}
