Procedure Name: Progestin Implant Removal
Indication for Removal: ** Abnormal bleeding / Desires pregnancy / Due for Removal / Side effects / Other
Location / Side: ***
Pre-Procedure Diagnosis: ***
Post-Procedure Diagnosis: ***, removed
Informed consent: Procedure, alternate treatment options, risks, and benefits were thoroughly explained to the patient and informed consent was obtained before the procedure started. Risks of the procedure include (but are not limited to) bleeding, infection, difficulty with removal, scarring, and nerve damage. There may be bruising at the site of incision and down the arm.
Equipment for procedure available.
The appropriate time-out was taken. The procedure was confirmed by patient and team. The position correct for the procedure.
The patient is placed in the supine position. Aseptic conditions are maintained. The rod is located by palpation. The area is cleaned with antiseptic. (NUMBER) cc of 1% lidocaine with epinephrine is injected just underneath the end of the implant closest to the elbow. After firmly pressing down on the end of the implant closer to the axilla a 2-3 mm incision is made with a scalpel. The rod is pushed to the incision site and grasped with a mosquito forceps and gently removed. Blunt dissection (WAS/WAS NOT) needed. The patient (DID/DID NOT) tolerate the procedure well. The 4 cm rod was removed in its entirety. The incision was dressed with a small adhesive bandage closure and a pressure dressing was applied.
An alternate plan for contraception was discussed. The patient would like to use (CONTRACEPTIVE METHOD) for her contraception. She was given a detailed instruction sheet about her desired method of contraception.
Reference
http://www.reproductiveaccess.org/wp-content/uploads/2014/12/implant_removal_note.pdf