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Thoracentesis is a procedure to remove fluid from the space between the lungs and the chest wall called the pleural space. It is done with a needle (and sometimes a plastic catheter) inserted through the chest wall. Ultrasound pictures are often used to guide the placement of the needle. This pleural fluid may be sent to a lab to determine what may be causing the fluid to build up in the pleural space.
If you are unable to seat the patient due to hemodynamic status, mental status or because of tubes and indwelling lines, the Thoracentesis has to be done in the supine position. Turn the patient on his side and bring his back to the edge of the bed. You will be able to accomplish the Thoracentesis in this position. Be aware that the dependent diaphragm moves up. Let me show you a lateral decubitus chest x-ray to demonstrate the upward movement of the dependent diaphragm. Select the 5th or 6th interspace to avoid possible injury to the diaphragm.