Now that you are familiar with the procedure, complications and limitations of a pleural biopsy, we are now ready to discuss obtaining a consent from the patient. I always stress how I am going to make the procedure as painless as possible. Hopefully, the patient had a painless thoracentesis. If the patient had a painful thoracentesis, he is going to be less convinced of your reassurance!
Describe how you are going to take pieces of lining from the chest and the lung will never be touched. You should mention the risk of a pneumothorax and bleeding. Play this down, as the chances are rare. You should explain ahead of time that it may be necessary to repeat the procedure if the first biopsy is non-diagnostic. If the patient is forewarned of this possibility, he won't think an error was made the first time.
Preprocedure Screen:
I routinely check for history of coagulation disorders and intake of anticoagulants.
Additionally, I obtain a PT, PTT and platelet count. Possible allergies to local
anesthetics should also be asked for.