Fine Needle Aspiration Biopsy of the Thyroid: Clinical Protocol

Pre-Procedure Requirements

Patient Preparation

• Review patient's medical history and coagulation status
• Verify discontinuation of anticoagulants if applicable
• Obtain informed consent
• Position patient supine with neck extended

Equipment Needed

• Ultrasound machine with high-frequency linear transducer
• 23-25 gauge needles
• 10mL syringes
• Antiseptic solution
• Sterile drapes and gloves
• Glass slides and fixative solution
• Specimen containers

Procedure Steps

1. Initial Setup

1. Perform ultrasound examination to identify target nodule
2. Mark optimal approach path
3. Clean area with antiseptic solution
4. Apply sterile drapes

2. Biopsy Technique

1. Use ultrasound guidance to visualize needle path
2. Insert needle into nodule at optimal angle
3. Apply suction while performing 3-4 passes
4. Release suction before withdrawing needle
5. Prepare slides immediately

3. Specimen Handling

• Prepare minimum 4-6 slides per nodule
• Apply both air-dried and fixed preparations
• Label all specimens appropriately
• Complete requisition forms

Post-Procedure Care

Immediate Care

• Apply pressure to biopsy site
• Monitor for complications
• Provide post-procedure instructions

Follow-up

• Schedule result review appointment
• Document procedure details
• Arrange cytology review

Quality Assurance

Documentation Requirements

• Procedure notes
• Ultrasound images
• Specimen tracking
• Patient instructions provided

Risk Management

• Monitor for hematoma
• Assess voice changes
• Document any complications
• Follow infection control protocols

Contraindications and Precautions

Absolute Contraindications

• Uncontrolled bleeding disorders
• Patient non-compliance

Relative Contraindications

• Anticoagulation therapy
• Previous neck surgery
• Substernal thyroid extension