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Trick of the Trade: Peritonsillar abscess aspiration technique



An always popular topic is the drainage of peritonsillar abscesses. Sometimes it can be difficult to aspirate from a syringe using only one hand, especially with the awkward angle that you might encounter. I can never find syringes with the side rings to allow you to grasp the syringe more securely with one hand

Trick of the Trade: Peritonsillar abscess aspiration technique

Have an assistant apply negative pressure to a syringe connected to the needle using IV tubing.

Build a kit similar to the butterfly phlebotomy setup (above drawing).

  • Attach IV extension tubing to the spinal needle. 
  • Attach the other end of the IV tubing to the syringe. 
  • Ask the assistant to apply negative pressure on the syringe once you have penetrated the oral mucosal surface.
  • Now you can focus on just directing the needle to the appropriate area.


syringe 3ml

If you don’t have an assistant, you can also rig a VacutainerĀ® hub to the end of the extension tubing, again similar to a phlebotomy set up. Just imagine the same setup as below except with a spinal needle at the end instead of a butterfly needle.

Thanks to Dr. Nick Kanaan (Stanford-Kaiser EM co-chief resident) for telling me about his trick.


Photo #1 courtesy of Dr. Hagop Afarian (Fresno)

Michelle Lin, MD
ALiEM Editor-in-Chief
Professor and Digital Innovation Lab Director
Department of Emergency Medicine
University of California, San Francisco
Michelle Lin, MD