Contraceptive Implants Session IV A OneRod Implant Insertion

Contraceptive Implants Session IV A: One-Rod Implant Insertion Session IV A, Slide #1

One-Rod Implant Insertion: Required Equipment • An examination table • Sterile surgical drapes (optional) and gloves • Antiseptic solution • Local anesthetic, needles, and syringe • Implanon applicator • Skin closure, sterile gauze, and compresses Session IV A, Slide #2

Implanon Applicator Session IV A, Slide #3

Implanon Insertion: Step 1 • Have the client lie on her back with the arm that she doesn’t normally use flexed at the elbow and externally rotated. • Implanon should be inserted sub-dermally just under the skin. Session IV A, Slide #4

Implanon Insertion: Step 2 • Remove the sterile disposable applicator carrying Implanon from the blister pack. *If the implant is not seen, tap the top of the needle shield against a firm surface to bring the implant into the needle tip. • While keeping the shield on the needle, visually verify the presence of the implant, seen as a white body inside the needle-tip. * • Following visual confirmation, the implant should be lowered back into the needle. Session IV A, Slide #5

Implanon Insertion: Step 3 • Mark the insertion site with a marker. • Make 2 marks: – First, mark the spot where the rod will be inserted. – Second, mark a spot a few centimeters proximal to the first mark. This second mark will later serve as a direction guide during insertion. Session IV A, Slide #6

Implanon Insertion: Step 4 • Clean the client’s upper arm with antiseptic solution. Frame the insertion area with a drape that has an opening (optional). • Anesthetize the insertion area with anesthetic spray or by injecting 2 cc of 1% lidocaine just under the skin along the planned insertion tunnel). Session IV A, Slide #7

Implanon Insertion: Step 5 • Remove the needle shield. • Stretch the skin around the insertion site with thumb and index finger. Session IV A, Slide #8

Implanon Insertion: Step 6 • Insert the tip of the needle, at about a 20 degree angle. Session IV A, Slide #9

Implanon Insertion: Step 7 • Release the skin. • Lower the applicator to a horizontal position. Session IV A, Slide #10

Implanon Insertion: Step 8 • Lift the skin with the tip of the needle, keeping the needle in the subdermal connective tissue. • While lifting the skin, gently insert the entire needle. Keep the applicator parallel to the surface of the skin. Session IV A, Slide #11

Implanon Insertion: Step 9 • Break the seal of the applicator. Session IV A, Slide #12

Implanon Insertion: Step 10 • Turn the rounded end of the obturator a quarter turn, about 90 degrees. Session IV A, Slide #13

Implanon Insertion: Step 11 • Hold the obturator against the clients’ arm with one hand. With your other hand, slowly draw the needle out of the arm. • Never push against the obturator. Session IV A, Slide #14

Implanon Insertion: Step 12 • Check the needle to make sure the implant is absent. • After retraction of the cannula, the grooved tip of the obturator should be visible. Session IV A, Slide #15

Implanon Insertion: Step 13 • Verify the presence of the implant by palpating the site. • Apply a sterile gauze and wrap the arm with a pressure bandage. • Before the client is discharged, observe her for a few minutes for signs of bleeding from the insertion site. • Fill out the user card and give it to the client. • Review post-insertion instructions and other key messages. • Dispose of the applicator and syringe properly. Session IV A, Slide #16