Return to Contents

ARTHROCENTESIS

 

 

INDICATIONS:

 

 

ABSOLUTE CONTRAINDICATIONS:

 

 

RELATIVE CONTRAINDICAIONS:

 

 

MATERIALS:

 

 

PRE-PROCEDURE PATIENT EDUCATION:

Explain indications for procedure, technique, and possible complications. Obtain written consent when appropriate. Answer any questions the patient may have.

 

 

PROCEDURE/TECHNIQUE:

 

**See diagrams for specific joint landmarks

 

 

COMPLICATIONS, Prevention & Management:

         Infection can occur from introduction of skin bacteria into the joint space during the needle puncture. This complication can be limited by maintaining sterile technique and avoiding needle insertion through obviously infected skin.

         Bleeding is rarely a significant complication, but can occur in patients with bleeding disorders (such as hemophilia) or in patients who are taking anticoagulants. Arthrocentesis should be delayed until the clotting disorder has been reversed or enhanced with administration of specific clotting factors.

         Rarely, a local allergic reaction may occur from hypersensitivity to the local anesthetic. If it does occur, it is usually minor and can be treated with oral antihistamines. Monitor the patient for any signs of systemic allergic reaction or anaphylaxis. If there are signs of system reaction, this is an emergency and will require IV therapy, cardiac monitoring, and other treatments depending on the severity of the reaction.

 

 

DOCUMENTATION FOR THE MEDICAL RECORD:

Write a procedure note describing the indications for the procedure, skin preparation, sterile technique used, equipment and needle size used, amount and type of local anesthetic, number of attempts required, appearance and quantity of joint contents aspirated, type of dressing/splinting applied, lab studies ordered, and patient tolerance of procedure as well as complications.

 

 

ITEMS FOR EVALUATION:

         Understands indications/contraindications

         Educates/prepares patient

         Identifies proper landmarks

         Uses sterile technique

         Performs procedure correctly

         Understands potential complications and their management

         Adequate documentation performed