Arthrocentesis Flashcards
what must you avoid when you inject a joint?
articular cartilage
can be very damaging
why would you do a joint aspiration?
get out synovial fluid for analysis
- reduce pain and inflammation from effusion
- make them feel better
what is the leading cause of septic joint in young ppl?
gonorrhea
what are contraindications for injections?
infection cellulitis active tumor recent trauma or skin abrasion known bacteremia clotting d/o unstable joint weight-bearing tendon
which patients need extra concern with this procedure?
DM Immunocompromised Infection osteoporosis Hx of steroid flare
always do what before injecting a joint?
aspirate to check for infection
how long should pt wait before leaving after an injection?
30 min to r/o anaphylaxis
make sure to document what when doing an injection?
risks and benefits
when should you refer an injection?
hand/wrist
deep area (hip/SI)
nerve involvement
is a consent required for injecting a joint?
yes
how do you determine needle size?
consistency of fluid being injected
!8g (hyaluronic acid/septic arthritis)
22-25g (steroid)
25g (anesthetic)
what should you use to numb the area of injection?
ethyl chloride
lidocaine
what do you need to have when dealing with ethyl chloride?
everything ready, it wears off quick
how deep do you inject the needle?
1 inch
where is the neurovascular bundle located on each rib?
underneath the rib
what is an empyema?
pus pocket
what is chylothorax?
lymph material in the thoracic space
what happens in a tension pneumothorax?
trachia is moved away from midline
what size CT do you use for pneumothorax?
18-20F
what size CT do you use for fluid or blood?
32-40F
what is the most important equipment that needs to there before you perform a pneumothorax?
drainage system (pleurovac, glass bottles, heimlich valve)
how do you have to tape the chest tube?
occlusively (has to form a vacuum)
what do you have to do when you are done inserting chest tube?
chest Xray to see if the lung was reinflated
what is the normal amount of pleural fluid?
less than 20 ccs
