Joint Aspiration PRINT
I. Equipment (May vary between sites)
a. Contrast- Isovue 300/Omnipaque 240
b. Preservative free sterile saline (10mL)
c. Sterile Tray
i. Sterile Mayo Stand Cover
ii. Chlora Prep
iii. Sterile syringe tip caps
iv. Needles – (25G and 18G)1.5”, (18G 3.5”) (20G 3.5”) – Open as needed
v. Syringes – (2x(5mL)), (10mL) (Extra 5mL and 10mL syringes (unopened))
vi. Drapes- Tower drape x 2, Patient drape with hole
vii. Gauze 4×4 sponges
viii. Extension tubing
d. Sterile gloves
e. Biohazard bag
f. Sharpie & hemostat
g. 2” tape to move any excess tissue/ panniculus
h. Band-Aid
i. Mask
II. Personnel
a. Radiologist or RIA physician extenders
i. Responsible for obtaining consent
ii. Performs exam
b. Hospital Technologist
i. Prints order, reviews order with rad/RA
ii. Documents patient history and pregnancy status prior to exam
iii. Assists the radiologist or physician extender during procedure
iv. Patient care during injection and delivers fluid to the lab following aspiration
v. Provides patient with aftercare instructions & dismisses patient after 20 minutes
III. Procedure
a. Physician extenders must review all aspiration requests with an MSK radiologist
i. Please review any pertinent prior imaging
ii. Use the call center to connect with an available MSK rad (720-493-3777)
b. Consent
c. Time out
d. Identify and mark the injection site using fluoroscopy (Mask)
e. Prepare the injection site using aseptic technique
f. Local anesthetic
g. Needle placement
h. Aspiration attempt
i. The needle should be placed to the desired site under fluoro guidance, then aspiration is performed
ii. Contrast should not be injected before attempting the actual aspiration
iii. If the initial aspiration attempt fails to yield fluid, reposition needle at least once or twice and repeat aspiration
iv. If multiple aspiration attempts fail to yield fluid, contrast can be injected to confirm needle location
v. 5-10 cc of preservative-free sterile saline should only be injected after:
1. You have tried to aspirate, and nothing has come back
2. Confirming correct needle position with contrast
vi. Following successful joint aspiration, inject 1-2cc’s of contrast to radiographically confirm the aspiration site
vii. Small amounts of lidocaine and/or bupivacaine may be injected after aspiration for analgesia if requested
viii. Reserve drafted dictation for the consulted MSK radiologist
IV. Required Images
a. Save image with contrast
V. Special Considerations
a. Follow contrast allergy protocol