Table 1 Checklist for Procedures of Thoracentesis

1. Explain procedure to the patient, obtain a written informed consent;

2. Measure blood pressure;

3. Positioning the patient;

4. Recognizing the anatomic landmarks;

5. Percussion combine with CRX to determine the puncture site;

6. Wear hat, mask and gloves;

7. Checking equipment components;

8. Applying sterile technique;

9. Anesthetize the skin first;

10. Anesthetize deeper to pleura (just over the upper border of the rib);

11. Aspirate while advancing, and watch for color change;

12. Notice the depth of the needle advanced;

13. Change to the pleural puncture needle, advance carefully;

14. Aspirate while advancing until the color is the same as before;

15. Flexible the needle with nipper, connect the needle with drainage bag;

16. Aspirate the fluid slowly;

17. Let patient hold breath when withdrawing the needle;

18. Cover the puncture site with sterilized materials;

19. Send pleura fluid to lab for different examination;

20. Measure blood pressure again and have a auscultation;

21. Talk with patient to find any possible complications