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Taps for Removing Ascites Fluids

Emergency Medicine News: June 2016 - Volume 38 - Issue 6 - p 4
doi: 10.1097/01.EEM.0000484530.18054.eb


    Larry Mellick, MD, made a nice video on peritoneal taps. (“Peritoneal Taps for Removing Ascites Fluids,” EMN 2016; I have two questions, though.

    Why did he choose to hand pump? Was it just for demonstration purposes? It seems much more time-intensive, and I've always used the vacuum containers. Is there something I'm missing, like a safety issue?

    Is the Z-track insertion technique out of style? I thought it was still worth doing. Maybe I am out of date on that.

    Jeff Steele, MD

    Searcy, AR

    Richard Gordon, MD, the instructor in the video, responds: There is no safety issue that I'm aware of. We simply did not have the vacuum containers. We do use them when available. Great question about the Z-track. I don't think it is necessarily out of style because I know people who still deploy that technique. I was not trained to use that, however, and have not adopted it. I have not had a problem with post-tap leaking, but if I did, I would use Dermabond to cap it and perhaps reconsider my technique. I would not consider anyone who uses the Z-track technique out of date or wrong. I just think it's a matter of personal preference.

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