Tap that Knee! Basics of Arthrocentesis
Part 2 of a Series
Our series on joint care has given you a basic overview on knee arthrocentesis. Typically, it is not necessary to have an orthopedic consultant come to the bedside in the emergency department to do this procedure. Arthrocentesis is a procedure you can do well and feel confident about your technique.
Take a moment to review our last blog post on knee pain before reading this post and watching the accompanying video. (http://bit.ly/1Q7dG4h.) As always, review the anatomy; it plays a key part in successful bedside technique. Ultrasound-guided arthrocentesis is always a favored approach.
Although emergency physicians and advanced practitioners can complete this procedure at the bedside, we suggest contacting the surgeon involved for post-op patients before starting arthrocentesis. Most surgeons (if in-house at the time) will want to see a hot post-op knee. The surgeon may want to complete the procedure herself or omit a procedure if she does not feel it is necessary. Surgeons also may have concerns about antibiotics use (or misuse) and follow-up care for their patients.
The Approach
n Identification of knee effusion on physical exam
n Identification of knee effusion on plain radiograph
n Localized anesthesia prior to arthrocentesis of the knee
n Arthrocentesis of the knee
n Send laboratory testing including (but not limited to) cell count with differential, crystal analysis, Gram staining, bacterial culture(s), and sensitivity analysi...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
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