For a pediatric patient evaluated for thoracentesis, the recommended position is which of the following?

• A. Lying Supine
• B. Sitting Upright
• C. Prone
• D. Lateral Decubitus

Answer: (B)

When performing thoracentesis, gravity helps the pleural fluid settle into the posterior costophrenic space. Sitting upright with the patient leaning forward and arms supported provides the best, most accessible window to the pleural space and allows the clinician to palpate landmarks and insert the needle safely above the rib to avoid the intercostal vessels. In children, this position is generally well tolerated and complements ultrasound guidance for locating the effusion. Lying flat or prone makes the fluid harder to reach and can increase the difficulty and risk of lung injury, while a lateral decubitus position is used mainly when a patient cannot sit up or when comparing sides.