Medications should be reviewed by medical and nursing staff and arrangements made by the medical team for alternative anticoagulant and diabetic medication if necessary. A local anaesthetic, such as lidocaine 2%, is infiltrated into the area where the biopsy is to be taken. In some cases, where the patient is extremely anxious, conscious sedation may be considered (Al Knawy and Shiffman [5]).

Nursing staff should take a nursing history, reviewing social and medical history and determining allergy status. Up to 7 days prior to the procedure, the referring medical team must ensure that a full blood count, clotting screen and biochemistry have been taken. Nursing staff should review bloods as part of their pre‐procedure assessment. If a patient is currently taking an anticoagulant such as warfarin, a clotting sample must be taken within 24 hours of the procedure.

A baseline set of physiological observations must be undertaken. If conscious sedation is used, the patient must be nil by mouth and they must have patent intravenous access (Academy of Medical Royal Colleges [1], Australian and New Zealand College of Anaesthetists [8]). The patient is usually in the supine position with the right side as close to the edge of the bed as possible. The left side may be supported by a pillow. The patient's right hand is positioned under their head and their head turned to the left. Oxygen therapy may be required if there are pre‐existing conditions or when conscious sedation is used. The patient may be asked to hold their breath at the end of expiration so nursing staff should explain this prior to the procedure (Karamshi [112], Pagana and Pagana [177]).