Where is the needle placed when treating a pleural effusion?

Where is the needle placed when treating a pleural effusion?

• A. 6th or 8th intercostal space, above the rib
• B. 2nd intercostal space, midclavicular
• C. 3rd intercostal space, anterior
• D. 10th intercostal space, posterior

Answer: (A)

When draining a pleural effusion, the needle is placed into the intercostal space of the lateral chest and entered just above the upper border of a rib. This above-the-rib approach protects the intercostal vessels and nerves that run along the inferior border of each rib, reducing the risk of bleeding and nerve pain. The fluid tends to collect at the lung bases when the patient is upright, so the safest and most effective access is in the lateral chest around the midaxillary line at a lower intercostal space (typically around the 6th to 8th spaces, depending on body habitus). This combination—lateral access and entry above the rib—balances accessibility to pleural fluid with protection of surrounding structures.

When draining a pleural effusion, the needle is placed into the intercostal space of the lateral chest and entered just above the upper border of a rib. This above-the-rib approach protects the intercostal vessels and nerves that run along the inferior border of each rib, reducing the risk of bleeding and nerve pain. The fluid tends to collect at the lung bases when the patient is upright, so the safest and most effective access is in the lateral chest around the midaxillary line at a lower intercostal space (typically around the 6th to 8th spaces, depending on body habitus). This combination—lateral access and entry above the rib—balances accessibility to pleural fluid with protection of surrounding structures.