Anatomy of the elbow
The elbow joint is found between the humerus, radius, and ulna. Using a lateral approach for arthrocentesis, you will access the elbow joint between the olecranon, the radial head, and the lateral epicondyle of the humerus.
Ideal positioning for arthrocentesis of the elbow
For an elbow arthrocentesis, or elbow tap, you need to properly position your patient:
- The patient is sitting down
- The affected elbow is flexed at 90°
- The hand is pronated (face down) on the surface
Pronating the hand will move the radial head out of the way of the elbow joint.
How to perform arthrocentesis of the elbow
The arthrocentesis procedure requires six simple steps to ensure a safe, clean, and painless elbow tap:
- Direct your 20 gauge (G) needle between the lower part of the radial head and the lateral epicondyle of the humerus, being sure to stay above the olecranon.
- Keep the needle parallel to the surface, and perpendicular to the arm (lateral approach).
- Aspirate as soon as your needle enters the skin.
- Stop advancing the needle when you see fluid.
- Extract the joint fluid.
- Take the needle out and apply a bandage.
Fantastic job! You have covered the basics of an elbow arthrocentesis procedure.
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- Roberts, J. 2019. “Arthrocentesis”. In: Roberts and Hedges’ Clinical Procedures in Emergency Medicine and Acute Care. 7th edition. Philadelphia: Elsevier.