Ingenuity

Necessity is the mother of invention. Health care workers are always inventing little things with whatever is around (MacGyver-style) to make our lives (and our patients’) easier. Here is such an example. A patient came in the other day with massive ascites from hepatic failure and required a paracentesis (draining the fluid from the abdomen). Usually, you just attach to tubing to vacuum bottles that automatically sucks the fluid into them. They are usually in short supply though. Also, you often have to drain a lot more than a litre of two off these folks (this guy had 8 litres taken off – and was admitted for some gentle IVF to avoid post procedural hypotension) so you need a lot of bottles. I remember just letting the excess liquid drip by gravity into an open container – but Man, it is SLOW. What if you could just somehow attach the IV tubing (which is used to connect the angiocath or needle that is inserted into the abdomen) from the patient indirectly to wall suction? The tubing is too thin to attach directly to the container. Here is my colleague’s invention. She and the RN attached the 3cc syringe to the input of the suction container (luckily you can just jam the back end into the opening) and removed the plunger from it. They then attached a three-way stopcock to the end so that the flow of fluid could be regulated with the lever (modifying the suction strength and the rate (via the stock cock) optimises the flow so that you can achieve rapid suction without collpasing the thin IV tubing).

Worked brilliantly!