Thoracentesis

I had the chance to follow an attending to a clinic when he was teaching a resident how to perform a palliative thoracentesis and I have to say the devices they used looked a lot like chem lab.  There were 2 different sized needles, one to puncture the back of the patient and the other to collect the fluid that had accumulated in the patient's pleural cavity.  This was a very skinny patient but you could tell he was working hard to breathe because of the fluid.  The resident had never done this procedure before but he had a bit of trouble working a 3 way stopcock that would allow the fluid to drain into bag once it was suctioned.  The attending was getting a little frustrated because he was on a schedule so he helped the resident do most of the procedure, which is good for the comfort of the patient but in my opinion doesn't really help the resident learn the technique.  It's difficult to learn at first for sure because it's a blind technique, using percussion and rib markers to determine where to puncture.  I'm sure he'll have more opportunities to practice and the patient was starting to get uncomfortable - he had to get punctured twice because the first time we couldn't get enough liquid out.  Definitely interesting to see but I don't think I'd be able to do something like that!