Exam Protocol

Hip Aspiration

Department / Diagnostic Radiology
Supplies / sterile procedure tray 10cc syringe
18g needle betadine prep
leur lok plug (to cap off syringe) sterile gloves for PA / Radiologist
preservative free sterile saline 22g spinal needle
Have weights and a variety of sponges for positioning available.
Be sure that a blue card has been requested from the lab and that adequate labels are available for the specimen.
Set up /
Procedure / Set up sterile procedure tray – label all syringes.
Do not put 10cc syringe or extra needle on tray and do not draw up the preservative free sterile saline until it is determined that this will be necessary.
(Leslie Manning wants .2ml of Neut drawn up with the local anesthetic.)
Get a complete history, double check the orders for the exam and discuss the procedure with the PA and the Radiologist working the ortho slot.
Consent the patient, position the patient for the procedure.
Before the PA begins the procedure, conduct a time out.
The PA will prep and drape the patient and will perform the aspiration. If no aspirate is obtained initially, an injection of preservative free saline into the joint space may be required.
If the PA is unsuccessful in obtaining an aspirate from the joint space, the Radiologist should be consulted, and asked to attempt the aspiration. If the Radiologist fails to obtain an aspirate as well, the Radiologist must contact the referring physician to discuss further options.
(While fluoroscopy is the preferred imaging modality for these exams, the Radiologist may want to attempt the procedure using Ultrasound)
If aspirate is obtained, it must be properly labeled and sent to the HFH laboratory in a biohazard bag. The aspirate may be sent to the lab in the syringe – but the syringe must be capped off. (Do not use a needle to cap the syringe) Be sure to put an ICD-9 code on the lab requisition.
The patient should be given a post procedure instruction sheet before being released.
Filming / A copy of the order for the exam should be scanned and at lease one image of the procedure obtained. The on line form should also be completed, including fluoro time.
Last Reviewed / 1/08