Page 248 - ATP-P 11th Ed

JOINT INFECTION PROTOCOL

SPECIAL CONSIDERATIONS
1. May result from penetrating trauma (especially animal or human bites), gonorrhea,
or iatrogenic causes (i.e., attempted aspiration of joint effusion).
2. Consider also an acute joint effusion due to blunt trauma or overuse (usually less
red and no fever).
SECTION 2 Signs and Symptoms

1. History of adjacent penetrating trauma or infection
2. Single red, swollen joint
3. Fever
4. Pain
5. Joint is swollen, with a tense effusion, and overlying erythema extending beyond the
joint. Exam will most likely also have tender, swollen groin nodes in this patient with
an infected knee joint.
Management
1. IV access
2. Ceftriaxone (Rocephin ) 2g IV/IM bid OR ertapenem (Invanz ) 1g IV/IM daily
®
®
3. Treat per Pain Management Protocol.
4. If evacuation is prolonged and pain is unresponsive to analgesia, consider draining joint
(if properly trained)
5. IMMOBILIZE THE JOINT.

Disposition
Priority evacuation

Joint is swollen, with a tense effusion, and
overlying erythema extending beyond the
joint. Exam will most likely also have tender,
swollen groin nodes in this patient with an
infected knee joint.

238 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 239