Assessment of Malignant Pleural Effusion (AMPE) Clinic

The Assessment of Malignant Pleural Effusion (AMPE) Clinic aims to improve the care of patients with pleural effusions due to malignancy.

Our team offers services for new assessments of malignancy proven effusions, insertions of intrapleural catheters (IPCs), teaching for patients and families, drainage of the catheter, and appropriate follow up sessions.

Royal Jubilee Hospital Outpatient Endoscopy Unit serves as our base of operations. Our team of nursing unit clerks, registered nurses, respiratory therapists, and physicians are a knowledgeable, friendly, and compassionate group of health professionals that are especially trained to guide you during this difficult time.

Frequently Asked Questions

What should I expect during my visit to the AMPE clinic?

• Initial evaluations involve nursing team checking you in and verifying health information. The physician will provide a focused interview, clinical exam, and if appropriate, insertion/maintenance/removal of the chest tube.
• For new procedures, a chest x-ray will be performed to confirm placement of the tube.

What is an intrapleural catheter (or PleurX©)?

• An interpleural catheter is a flexible small tube that is placed in the pleura (i.e. the space between the ribs and the lungs).
• It is a semi-permanent tube that is designed for repeated drainages to help alleviate recurrent breathing issues due to reaccumulating fluid in the pleura. 
• It allows patients to stay at home to drain their fluid with the help of homecare nurses, instead of needing in-hospital drainages.

Do I need to fast before my procedure or appointment?

No, you do not. We recommend eating a light breakfast prior to your appointment.

What medications should I be stopping prior to the procedure?

• Continue to take your medication as prescribed, unless otherwise instructed by the AMPE clinic or your physician. 
• Inform the AMPE clinic or your physician if you are taking   blood thinner(s) (i.e. antiplatelets – Aspirin, clopidogrel, ticagrelor and/or anticoagulation – warfarin, rivaroxaban, apixaban, heparin) as these may need to be held prior to the procedure.
• Please do not stop taking these medications without consultation from your physician or the AMPE clinic.

Can I bring a support person?

• Yes, however given the limited space, we cannot accommodate more than one person.
• During the insertion of the catheter, your support person will be kindly asked to leave and wait in a designated area.

Can I drive home after the procedure?

• We recommend that someone drive you to and from the procedure.

FOR PRACTITIONERS 

Referral Requirements (referral is required by a nurse practitioner or physician)

• Completion of Referral form **incomplete forms will result in delays or rejection of requests***
• Referral Form
• Physician Tips
  • Insertion of pleural catheters is NOT available after hours OR on weekends.
  • AMPE will aim to see patients within 1-2 weeks of receiving a completed referral.
  • If your patient is experiencing significant symptoms due to the pleural effusion (i.e. chest tightness/pain, dyspnea, hypoxemia), we recommend organizing an URGENT thoracentesis IMMEDIATELY rather than wait for a pleural catheter insertion.
  • HELPFUL information for the AMPE clinic includes: DIAGNOSIS of the pleural effusion, FULL MEDICAL HISTORY of the patient, and FREQUENCY of drainages – this helps our team provide timely and appropriate appointments.
  • Contact the Respirologist ON-CALL for further advice if required.