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*This information is being made available by Advanced Practice Education Services, LLC for educational purposes only. This material is not
intended to represent the best, nor only method appropriate for every medical situation. Every effort has been made to assure the accuracy of
the data-Providers are recommended to check specific drug dosages with other resources prior to applying this information to their practice.
Supervised clinical experience is recommended. Providers should consult their specific state boards for scope of practice issues prior to
performing these injections
The procedure was explained to the patient in detail, all questions were answered. An informed consent
was obtained. The patient was positioned, the shoulder was draped appropriately. Anatomical
landmarks were identified. The skin was prepped with _________ in the usual fashion. Using strict
sterile technique a ____ gauge, _____ inch needle was inserted using the posterior approach into the
joint space. After negative aspiration, ___ccs (anesthetic) with ____mg (corticosteroid) was injected
into the joint space. Needle was removed- sterile bandage was applied. The patient was observed in the
office for _____ mins without complications. Patient noted ________( % of improvement) after
procedure. Post injection instructions, including s/ss of complications were discussed. The patient will
return for follow post injection evaluation in ______.
The procedure was explained to the patient in detail, all questions were answered. An informed consent
was obtained. The patient was positioned, the shoulder was draped appropriately. Anatomical
landmarks were identified. The skin was prepped with _________ in the usual fashion. Using strict
sterile technique a ____ gauge, _____ inch needle was inserted using the ______________(posterior or
lateral approach) below the subacromial process. After negative aspiration, ___ccs (anesthetic) with
____mg (corticosteroid) was injected without resistance. Needle was removed- sterile bandage was
applied. The patient was observed in the office for _____ mins without complications. Patient noted
________( % of improvement) after procedure. Post injection instructions, including s/ss of
complications were discussed. The patient will return for follow post injection evaluation in ______.
The procedure was explained to the patient in detail, all questions were answered. An informed consent
was obtained. The patient was positioned appropriately, the knee was flexed to (60-90) degrees.
Anatomical landmarks were identified. The skin was prepped with _________ in the usual fashion. Using
strict sterile technique a ____ gauge, _____ inch needle was inserted one finger width above the (medial
or lateral) tibial plateau (medial or lateral) to the patellar tendon into the joint space. After negative
aspiration, ___ccs (anesthetic) with ____mg (corticosteroid) was injected without resistance. Needle
was removed- sterile bandage was applied. The patient was observed in the office for _____ mins
without complications. Patient noted ________( % of improvement) after procedure. Post injection
instructions, including s/ss of complications were discussed. The patient will return for follow post
injection evaluation in ______.
*This information is being made available by Advanced Practice Education Services, LLC for educational purposes only. This material is not
intended to represent the best, nor only method appropriate for every medical situation. Every effort has been made to assure the accuracy of
the data-Providers are recommended to check specific drug dosages/material with other resources prior to applying this information to their
practice. Supervised clinical experience is recommended. Providers should consult their specific state boards for scope of practice issues prior
to performing these injections