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For superficial aspirates, alcohol preparation
technique suffices for cleansing of the skin surface. Local anesthetic
usually is not necessary. If multiple passes of deep seated lesions
are anticipated, anesthetic is recommended. However, be certain
not to contaminate the lesion with a large volume of anesthetic
solution. Local anesthetic may interfere with the ability to
palpate and localize superficial lesions. Sterile technique for
deep aspirates is required for cleansing of the skin and local
anesthetic is usually required.
a) Assemble the syringe pistol with attached
needle and lay out several glass slides with alcohol fixative.
b) Clean the skin at the puncture site with an alcohol pad.
c) Lay the needle point on the skin over the puncture site and
determine the angle of approach to the mass. A “fine needle”,
22 gauge or smaller diameter (e.g. 23, 25 gauge) is used.
d) Hold the lesion firmly stationary with the free hand and insert
the needle in one swift motion.
e) Determine that the mass has been penetrated either by noting
the resistance encountered on puncture or by moving the syringe
slightly from side to side while feeling the mass move beneath
the finger of the palpating hand.
f) Apply full vacuum pressure to the syringe with the pistol
finger.
g) Move the needle back and forth within the mass at slightly
different angles while full pressure is maintained.
h) Observe the hub junction of the needle and syringe for the
appearance of any sample or continue to make multiple back and
forth passes within the mass lesion.
i) Conclude the aspiration at the first appearance of any sample
within the syringe or after multiple passes by releasing the
trigger of the syringe pistol. Vacuum pressure is applied to
the syringe ONLY when the needle is within the mass. If vacuum
pressure is applied while withdrawing the needle air and sample
will be pulled into the syringe where it will dry and be difficult
to retrieve.
j) Withdraw the needle from the mass and place pressure on the
puncture with a sterile gauze pad to minimize blood. No vacuum
pressure should be applied to the syringe during withdrawal of
the needle.
k) Once the needle has been removed from the patient, the needle
is detached from the syringe so that the syringe can be filled
with air. The needle is then reattached (see
Figure 1), and sample is expressed for the needle onto the
glass slide. The sample is then delicately smeared between two
glass slides (Figure 2).
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Fine Needle Aspiration Collection
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