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