epd thoracentesis Archives

The EPD’s Role in Thoracentesis Safety

Thoracentesis procedures require patients to maintain a difficult, forward-leaning position. Maintaining this position often leads to instability and placing significant physical strain on nursing staff who must manually support them. This scenario presents a dual risk. First, patient safety can be compromised by sudden movements. Second, caregivers are exposed to a high risk of musculoskeletal injury. The innovative application of the Epidural Positioning Device (EPD), traditionally used for spinal anesthesia, offers a superior solution for supporting patients during thoracentesis.

This article explores how this versatile device enhances patient stability. This article also dives into how the EPD improves procedural accuracy, and crucially, reduces the risk of injury for hospital staff. The EPD represents a pivotal advancement in Safe Patient Handling (SPH) by providing a secure, ergonomic, and hands-free solution for complex procedural positioning. It is a comprehensive tool that directly addresses staff safety and patient outcome goals.

The Dual Challenge of Thoracentesis Positioning

Performing a thoracentesis involves navigating significant risks for both the patient and the clinical team. The need for a specific patient posture creates a situation where safety can be easily compromised.

The Risk to Patient Safety and Procedural Success

The required forward leaning “tripod” position is inherently difficult for many patients to maintain. For elderly, frail, or bariatric individuals, holding this posture without support is uncomfortable and often impossible for the duration of the procedure. This instability is a major concern. Any sudden patient movement can compromise the sterile field, damage surrounding tissue, and increase the risk of serious procedural complications, such as a pneumothorax. Patient comfort and stability are not just matters of satisfaction; they are directly linked to clinical success.

The Unseen Burden on Healthcare Staff

When a patient cannot hold the position independently, the responsibility falls to the nursing staff. Manually supporting a patient, sometimes for extended periods, places an immense physical burden on caregivers. According to OSHA, healthcare workers are at an extremely high risk for musculoskeletal injuries (MSIs) from manual patient handling. The sustained, awkward posture required to hold a patient during thoracentesis can lead to career-altering back and shoulder injuries, contributing to lost workdays and burnout. This manual approach is a clear violation of modern SPH principles.

The Innovative Solution: Applying the Epidural Positioning Device

The EPD offers a simple, effective, and innovative solution to this long-standing problem. By repurposing this proven technology, facilities can transform thoracentesis from a high-risk procedure into a safe and controlled one.

What is the Epidural Positioning Device?

The EPD is a fully adjustable positioning aid designed to securely support a patient’s torso, head, and arms in a flexed, forward-leaning posture. Originally developed to provide stable positioning for epidurals and spinal blocks, its design is perfectly suited for other procedures requiring similar posture. Key features include locking wheels for stability, an adjustable chest and face cradle for customized support, and secure armrests. It mechanically holds the patient in the ideal position, freeing the caregiver from the task.

Why It’s the Gold Standard for Thoracentesis

The EPD is the gold standard for thoracentesis because it perfectly mimics and secures the ideal patient position without any need for manual holding by staff. It provides unwavering stability, allowing the practitioner to focus entirely on the procedure with an immobile patient. This hands-free positioning ensures the patient remains stable and comfortable, which directly enhances procedural accuracy and reduces the likelihood of complications. The device essentially creates the perfect clinical environment for success.

The Compounding Benefits of a Safer Procedure

Integrating the EPD into procedural workflows provides compounding benefits that align with key performance indicators for safety and efficiency.

Revolutionizing Staff Safety and Workflow

The most significant benefit for staff is the complete elimination of manual holding. This directly aligns with national Safe Patient Handling standards from the ANA and AORN, which advocate for the use of technology to eliminate high-risk manual tasks. By using the EPD, facilities candramatically reduce the risk of debilitating back and shoulder injuries among their nursing staff.

This also leads to improved workflow efficiency. A task that once occupied one or two staff members for the entire duration of the procedure can now be managed by a single person who sets up the device. This frees up valuable clinical staff to perform other critical duties, improving departmental productivity.

Maximizing Patient Safety, Comfort, and Dignity

For the patient, the advantages are equally compelling. The stable, ergonomic support provided by the EPD improves comfort and significantly reduces the anxiety associated with the procedure. A stable patient is a safe patient. By minimizing the risk of sudden movements, the EPD contributes to better clinical outcomes and fewer complications. Furthermore, being supported by a piece of medical equipment rather than being physically held by staff members enhances the patient’s sense of dignity and autonomy.

The application of the Epidural Positioning Device for thoracentesis procedures is a powerful example of innovative thinking in patient care. The EPD transforms a high-risk task into a safe, stable, and efficient process. Importantly it providies standardized solution that protects both patients and invaluable hospital staff. By embracing this technology, facilities make a clear commitment to a culture of safety, directly addressing the well-being of their caregivers while simultaneously improving patient outcomes.

Elevate your facility’s commitment to a culture of safety. Contact SPH Medical to discover how the versatile Epidural Positioning Device can be integrated into your procedural areas to reduce injuries and improve patient outcomes.

What is Thoracentesis and what are the risks to patients and staff?

Thoracentesis is a procedure to remove the excess fluid that is found in the space between the lungs known as the pleural cavity. This is also sometimes called a Pleural Tap. The accumulation of fluid in the plural cavity is called pleural effusion. According to hospital staff patients with many different conditions or diagnosis experience this issue. Thoracentesis is performed for both diagnostic reasons, to determine why pleural effusion is occurring, and therapeutic reasons; to relieve the pressure on the lungs making it easier to breath, reduce pain, and shortness of breath. Patients can be seen in doctors offices and hospitals to drain this excess fluid. There are several key clinical staff members that are often involved in this procedure. In the hospital setting, thora’s are often performed in the imaging department.

Why the imaging department?

The imaging department is often the most common location to perform thora’s because the experts in ultrasound technology have the equipment needed to locate the right location in the rib cage to insert the needle for drainage. Sonographers are often tasked with all the patient prep and set up required to get the patient ready for the procedure. The pulmonologist will arrive after the patient is prepared perform the procedure.

Patients are typically sitting comfortably at the edge of a chair or bed and asked to lean forward over a table with a stool supporting their feet.

Once the sonographer has identified the correct location the doctor will clean the location and insert a local anesthetic to numb the area. Then the doctor will insert the needle between the ribs and into the pleural space to drain the fluid. The trained ultrasound staff will monitor the patient as the fluid is drained over 10-20 minutes. In some cases this will take longer.

What are the risks to patients?

There are several risks related to this procedure that are documented by the National Heart, Lung and Blood Institute. Rare complications include liver or spleen injuries. More common risks include a collapsed lung or pneumothorax, pain, bleeding, bruising, or infection.

Protecting patients and hospital staff

Over the last 10 years the healthcare industry has made significant progress nationally reducing risk of injury to nursing and hospital staff. It has been well documented by the CDC/NIOSH and American Nurses Association after years of research by the Veteran’s Health Administration that clinical staff of all disciplines are at risk of career ending Musculoskeletal Disorders from manually lifting, moving, and positioning patients. Using Safe Patient Handling and mobility devices reduces a caregiver’s risk of injury and improves the safety and quality of patient care.

The EPD for Thoracentesis

A large University Medical Center’s Imaging department first contacted us in 2019 about Thoracentesis and the manual positioning issues they were facing. They described the unstable bedside table with non-locking wheels that they were having their patients lean over and the static holds that their staff were having to perform. The Imaging Director felt that their sonographers were manually positioning patients and being put at risk of injury. One staff member was injured which made finding a solution a top priority. In addition to staff injury concerns, patients were at risk of falling due to the current procedure of using the unsafe bedside table. They needed a better solution. The Epidural Chair or EPD seemed like a perfect fit. The head support, arm rests, and foot plate can all be positioned to support the patient safely and comfortably. They were excited to explore the use the EPD to support patients during this procedure. After an onsite evaluation the feedback was unanimous. The pulmonologists and sonographers all agreed that the EPD was the ideal solution to reduce risk of injury to staff and to improve patient safety and comfort. Today the EPD for Thoracentesis procedures is becoming the new standard of care for patient and staff safety.

SPH Medical was founded on the principals of improving workplace safety for our frontline caregivers and improving patient outcomes through Safe Patient Handling and mobility across the entire continuum of care, from the ICU to home. Contact SPH Medical to request more information.

epd thoracentesis

Epidural Positioning Device for Thoracentesis Safety