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 (see photo above).
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.
If you don’t have an assistant, you can also rig a vacutainer 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)