ABSTRACT
Do remember, as always, if you are unsure at any stage as to the cause of radiological appearances, seek senior advice or speak to a radiologist. If the patient is not in extremis, an ultrasound of the chest can help confirm the presence of an effusion and whether it is loculated. The best position for access and also depth of effusion from the skin can also be marked. Ultrasound can be performed in the radiology department or on the ward. Risks of pleural aspiration include infection, bleeding and pneumothorax. Consent the patient appropriately, document all procedural aspects in the patient notes and arrange and review the post-drainage/aspiration chest radiograph. In some institutions, pleural drain insertion is only done under ultrasound guidance by a radiologist to minimize such risks to the patient. When fluid is drained, this patient will need CT of the chest/abdomen to assess the underlying cause.
