Contraceptive Implants Session IV A OneRod Implant Insertion

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

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

Implanon NXT Applicator Remove the sterile Implanon NXT applicator with the preloaded implant from the package by allowing it to fall on the sterile tray without touching it. Session IV A, Slide #3

Implanon NXT Insertion: Step 1 • Place a clean, dry cloth under the woman’s non dominant arm ( ensure that woman has washed her arm with soap and water) and position the arm with the elbow flexed and the hand under the head. • Mark the position on the arm for the rod’s insertion, 8 -10 cms from the medial epicondyle and 3 -5 cms below the sulcus between the biceps and triceps muscles. Session IV A, Slide #4

Implanon NXT Insertion: Step 2 • Clean the client’s upper arm with antiseptic solution using a sterile tissue forceps to hold the gauze/cotton and drape the arm with a sterile cloth with a hole. • Inject 1 -2 ml of 1% lidocaine just under the skin, raising a wheal at the insertion point and advancing up to 5 cm along the insertion track. Session IV A, Slide #5

Implanon NXT Insertion: Step 3 • Hold the applicator just above the needle at the textured surface area and remove the transparent protection cap by sliding it horizontally away from the needle • You should be able to see the white implant by looking into the tip of the needle • Do not touch the purple slider until you have fully inserted the needle subcutaneously, as it will retract the needle and release the implant from the applicator. Session IV A, Slide #6

Implanon NXT Insertion: Step 4 • Stretch the skin around the insertion site with thumb and index finger. • Puncture the skin with the applicator at a 30 degree angle. Insert only the bevel of the needle • Lower the applicator to a horizontal position • While lifting the skin with the tip of the needle, slide the needle to its full length Session IV A, Slide #7

Implanon NXT Insertion: Step 5 • While keeping applicator in the same position and the needle inserted to its full length, unlock the purple slider by pushing it slightly down • Move the slider fully back until it stops, leaving the implant in its final position and locking the needle inside the body of the applicator • Gently remove the applicator leaving the implant in place Session IV A, Slide #8

Implanon NXT Insertion: Step 6 • Verify the presence of the implant by palpating the site. • Have the woman palpate the implant Session IV A, Slide #9

Implanon NXT Insertion: Step 7 • Apply a sterile gauze and wrap the arm with a pressure bandage. Session IV A, Slide #10

Post Insertion steps • Before removing gloves, Ø Disposes the used needle (without capping) and the single use applicator in a sharp’s container, Ø Wipes the non-disposable instruments with a wet cloth or soak in water at point of use to remove any tissue or blood before further cleaning and processing. Ø Disposes the waste materials like cotton, gauze in leakproof container or plastic bag Ø Decontaminates surfaces that may have been contaminated by blood, such as the procedure table or instrument stand, by wiping them down with 0. 5% chlorine solution. • Remove gloves by turning them inside out and disposing them in a leakproof container or plastic bag • Wash hands with soap and water and dries them. Session IV A, Slide #11

Post-Insertion Instructions • Instruct woman about wound care and inform her that she can make a return visit appointment, if necessary. • If possible, give her a client card with details of date of insertion, type and batch number of implant, arm of insertion and date of removal. • Discuss what to do if she experiences any problems or sideeffects following insertion. She can return at anytime if she has any questions or concerns. • Assure her that she can have the implant removed at any time if she desires. • Ask her to repeat the instructions and answer her questions. • Observe the client for at least 15– 20 minutes before sending her home. Session IV A, Slide #12

Client Instructions for Wound Care at Home after Insertion • The client should keep the area around the wound dry and clean for 48 hours. • She can take off the pressure bandage after 2 days and the band aid/ surgical tape after 5 days. • Slight bruising, swelling at the insertion site is normal and will subside in a few days. • She can start doing routine work immediately. She should avoid lifting heavy weight, bumping or applying unusual pressure at the incision site. • After healing, the area can be washed and touched as usual. Session IV A, Slide #13