How to do an interventional procedure

Decide whether injection is appropriate

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A history and examination should be taken.
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Perform a diagnostic ultrasound to confirm diagnosis.
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Discuss with the patient what injection will entail and how it will be performed.

A history of the patient’s previous medical problems and medications is important.

Knowledge of the side effects of steroid and local anaesthetic is necessary.

1.

The World Health Organization protocol for procedures is followed to ensure patient identification, procedure confirmation and side and site selection.
2.

A trolley cleaned with antiseptic wipes is provided. Two persons check the names and expiry dates of all agents and packs.
3.

A sterile dressing pack is opened on the trolley.
4.

The operator washes his or her hands with antiseptic agents according to local protocol and dries his or her hands using a sterile towel.
5.

The operator puts on sterile gloves after cleaning his or her hands. The use of latex-free gloves is advised to avoid allergy.
6.

The skin is cleaned with antiseptic skin preparation according to local rules. The agent may be modified if there is a history of allergy to the standard material. The most commonly used agents are hibitane- and iodine-based compounds.
7.

Sterile needles, syringes and injectate are used and drawn up in a sterile way.
8.

The probe is cleaned with antiseptic according to the machine manufacturer’s advice.
9.

The probe is covered with a sterile probe cover, but the jelly under this cover does not need to be sterile.
10.

The contact ultrasound jelly used next to the patient should be sterile.
11.

A no-touch technique is used throughout the procedure, avoiding contact with the needle tip at any stage.