Management

Most physicians would feel safe in ordering a CBC following a pleural biopsy to monitor for hemorrhagic complications. However, I do not routinely order this. If bleeding occurred during the procedure or if we are dealing with a high risk patient for bleeding, we must closely follow the HGB and HCT.

I do not routinely obtain a chest x-ray following a biopsy. I obtain a chest x-ray only if the patient is symptomatic or if a complication (e.g., bleeding or pneumonia) occurred during the procedure. Unless you have evacuated the chest, no significant change occurs following the biopsy. It is a waste of time and money to obtain a post-biopsy film.

I usually perform a pleural biopsy as an outpatient procedure and do not feel that it is necessary to routinely obtain vital signs on a regular basis following the procedure.

Instruct the patient on the following:

• To take tylenol PRN for pain
• If the dressing soaks through, to change it
• The results will not be available for two days
• To resume normal activities
• To call should any new symptoms develop