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Temporal Artery Biopsy (102.126)

Temporal Artery Biopsy (102.126) - Policies, Clinical, UWMF Clinical, UWMF-wide, Clinical Policies and Procedures, Surgical

102.126

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UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION
CLINICAL POLICY AND PROCEDURE

TITLE: Temporal Artery Biopsy

Effective Date: February, 2005 Approval: See Authorization
Supersedes Protocol: None Contact: Clinical Staff Education

Reviewed Nov., 2007 May 2009 November 2011


PURPOSE: To provide guidelines for setting up and assisting with a temporal artery biopsy at UWMF clinics.

DEFINITION: The removal and examination of a portion of the temporal artery in order to diagnosis the
presence of disease, specifically arteritis.

POLICY: The clinical staff will utilize the following guidelines to set up and assist with a temporal artery
biopsy.

SUPPLIES: Permit for Operation, Provider’s order, Patient’s record, Sterile surgical tray, Clip applying
forceps, Ligating clips, Medicine Cup, Adson forceps without teeth, skin hooks, Small dissecting
scissors, Specimen container with formalin, 10cc syringe, 25G or 26G needle, Local anesthetic,
Suture material, Tegaderm, steri-strips or bacitracin, Cautery, Electrode pad and needle tip
electrode, No. 15 blade, Patient gown, Chux, Razor, Paper tape, Cotton ball, Sterile marking pen,
Gowns and sterile gloves, face shield

PROCEDURE:

1. Check provider’s order and clarify any inconsistencies.

2. Wash hands and gather equipment.

3. Using sterile technique open surgical tray and place any additional instruments needed on tray and recover
tray until needed.

4. Introduce yourself and identify the patient. Include date of birth. Verify allergies (specifically to betadine,
chloraprep and local anesthetic.

5. Provide good light and provide privacy by closing curtains and door.

6. Room patient – Refer to Provider Preference List for Rooming Patients.

7. Explain procedure to the patient.

8. Following the provider’s discussion with patient, have patient sign Consent for Operation and sign consent
form as witness.

9. Have the patient remove top clothing and have patient put on gown.

10. Have patient remove jewelry on affected side.

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11. Assist patient to the dorsal position and make patient as comfortable as possible.

12. Elevate table and adjust lighting.

13. Shave hair (if needed) around marked the area for biopsy.

14. Cleanse area with betadine or chloraprep.
NOTE: Use alcohol if patient is allergic to the other two.

15. Place cotton ball in patient’s ear of affected side.

16. Put on disposable gown.

17. Apply electrode pad to patient’s abdomen and hook to electrosurgical generator.

18. Attach cautery to the electrosurgical generator, press power button “on” and place settings to provider’s
preference.

19. Wash hands and put on sterile gloves and face shield.

20. Assist provider with procedure (as needed).

21. Place specimen in formalin container.

AFTER PROCEDURE

22. Remove gloves and wash hands.

23. Assist patient to comfortable position and with dressing (if necessary).

24. Reinforce postoperative instructions.
Give patient “Caring for the incision” handout
Review handout with patient, filling in blanks
Assist patient back to waiting room
Assist patient with follow-up appointment (if needed)

25. Handling of specimen
Label specimen, in presence of patient, with the following:
o Patient name and date of birth
o Specimen type
o Date and time of specimen collection
o Provider name
Complete necessary lab forms
Pace patient sticker into Pathology log book.
Take labeled specimen container to the lab





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26. Apply gloves and clean all surfaces with Dispatch
Bring surgical tray and instruments to dirty utility room
Place needles in sharps containers
Discard waste and disposable equipment in proper receptacles
Wash instruments and tray in dirty utility room
Remove gloves and wash hands
Bring instruments to clean utility room

27. Wrap surgical tray and instruments for sterilization.

28. Documentation (in Progress Notes section of HealthLink) in the patient’s record:
Patient education
the procedure performed, date & time completed
name and amount of any medications given (using SmartPhrase: .medinclinic)
how patient tolerated the procedure
discharge instructions
follow-up appointment (if any)

WRITTEN BY: Kelly Barman, R.N., Department of General Surgery

REVISED BY: Carol Decker, RN, MSN, Clinical Staff Educator

REVIEWED BY: Kelly Meyer R.N., Department of General Surgery

REFERENCES:

Kowalak, J. P. (Ed.). (2009). Lippincott’s nursing procedures (5th ed.). Ambler, PA: Lippincott Williams &
Wilkins.
Perry, A.G. & Potter, P.A. (2002). Clinical nursing skills & techniques. (5th ed.). St. Louis, MO: Mosby.
Perry, A.G. & Potter, P.A. (2009). Fundamentals of nursing. (7th ed.). Hall, A. & Stockert, P.A. (Eds.). St.
Louis, MO: Mosby Elsevier.


AUTHORIZATION:


Department of Surgery Date



Medical Director Date