Professional Documents
Culture Documents
Inteuded Ntlicrtions: Lojcrnim
Inteuded Ntlicrtions: Lojcrnim
Precrrutious e\acmtron. -\sress srgns ofurfection and address Note: The ,iuuu cruuurlae ald the flexble Kmm
All Ipas aspirators md carxrulae are ruturded for Bei-ort L:e.rfommq uterine er:acuatrot, any suious
th,-ur -4ses. the need for pain control nredication carnirlarsrre 4-10 require al adaptef to be ad{led to
rrtenue asplratioa.uterine eracuadolr iu obstelrics ald
ard adruinistu as needed the cmlrla,: irfire rlser{ed ilto the Ipas l$VA Plrrs
tredicll conditious tllat a-e present should be
gynecoloerc patients- Clilical indicatrols for rrterine
asprratiou are: treatrnant ofmcomplete ai:ortion for
uterine sizes rrp to 1? ueeks from last nqrstnml perio<l
addrersed irunrdiately These nclude: shock,
hunorrhage- cenical or pelvrc infrction- sepsis,
perforltron or abdominal ujuv as ntay occu'\1"1th
I[sErt
sprcuhuri.
Pofonn
cen:!cal
qr
-,6.i1)
Release the button(:) on th< aSpi.ator to trffilir the
r,acururr drrort-sh the caruurla iuto the uteruq- Blood
trsstt<- urd lrubbles should beEm 10 flolv througir ihe
carnrla hte, tlE a\ptrator
(I-bfP). and <ndomrrial biopry. inconrirletr alrortion or rurth cl.trdesti[e abortlot-
urtiseptr< For uterine er acrratiorr- e\-acuale the couterrts of
{-lterur evacuatiol rs often a[ iil]podut cofltporent
Applicatons fo- endonretrial biopsy nuy ilclrrde cas:s
of urt'enrlrt_v. abnonnd uterure bleedug- zuneuonhea.
of &-firltir.e nlflrng&uetrt in these cases and olce
prep lojcrniM
-r,&t$\* the rrtenrs by
rotating the
Prd-onu
and ::creening ior eldomeu ial cancer or screening for
tlre 1:ilrent rs stalxlized- the procedrre shoulc{ not be i+ cruurla l8(l
clelaytC. 1ruacen-ical t i--. ..-.- deglees in
block- as ,, -.:
endonetrral infections directron qhile
appropriarr
Histuy of blood dyscrasia uuy be a t:actor in dre usrng a gerlle
Coutlaindications rvoma['s care. In cases rt'here the rvonm hm a lustory . Dilatc rlc c:rrix. rf rcqured rn-ald out
Eldonretrial biopsy should lot be perfomrtd ir of a blmd-cloning disordtt the cmulae should be molioD
Note; For e'.rdoruetflal blopsy- cen ical dilatiou is
cas+ of :uspected preglucy, Thre are lo ktosn used c,nly rrrth rxheue cautiotl ancl olrll, irr faciirtie: ruely necei sary to allorr passaee of Jmn camnlae, Note: \\rlrerr
contmurdications for tleatnent of inconrplete abortion rvhae ftlll ernugmcy backup cue rs availatrle altirough rt nay be r.qrrired I some imtmces hr p<rforrnrne c'ndouetlal bropsy. uovemorr ol dre
for utmre sizes up to 11 rveeks LI,fP some qldalr{orrsl pnxicutrtrly tho:e n'ho are cauula rlsrde the rrteils rvill vary accordurg !o the
postmmopratxal. the cervix rny be sufficiantly puqrcse of tlre bropsl To take a silr1ple. mpuar.
Instlument Preparntion stenotic thai dilatiou and pasxge of a cmrtrla rs tot tis:ue by mr:r'irq the cumrla ueltly back ancl forth
Warnings . BeSin mdr the vak. butron(s) opflI (not drpressed), alolg tire arrttzior lrt.rm< rvall drel rotate tlle
porsrblc in :he outpatiflt settrug.
As mdr u1'rnr,asire procedue. thse rs r:sk of the phuleer posrtioled all dre rray in:rde thc cylnder. curula anc talie a umple tiorrr the postelor tteriue
and the collu stop loclied u place (*'ith the tabs rvall n the !]an]e nulu]tr A small anount of trssue ts
iofection to lxovrders- panents ad support staff
pustred dorrrr nto the holes ur the cylm€Itr), :.rtfEcient fcr diagrosrs n 81os! caser-
iluorrg1r contact with coltmuurt:. To mifiirnize the the rntrE
risk rnivesal prrcatrtiom must be obsen.ed at all ltrrhea prr{cuning ut.fltre elaclntiofl. if the aririlator
61ls up so tlnl slrclion stops, deprc:s rhe r-ah.e
tirue: Tbese urclurle using apprapriate bauers (ruch as .t- __ bunol(s) ar,d drscorurect the carurula frql t[:e
elorcs and rusks)- hmdling ruaste cuefu1lv md tahilg
prerautions to prevent inju-res
\
I
aspifator I eai e the camula rlserlerl ihorrsh the
ceri rcal os Eitlt:r rqrlaic tlrc arlrrr,::,r r), erulJty r{5
Uterme aspratron eracuation is a procedrue drat M;,
ii } tlterine A. pir'ntion/Evncuntior
. \\idr
Pr ocedure co[tills m:l thsn reattach !t ts drr camlla.
If the canmla becorues cloggecl. ease rt bach towrd.
isr-olvrs mniuul trarulu to thr trterus md cen ix. . -effiL'-:' dre rculum urser-ted hold the cen'ix steady
s1
1ffi", u.ith a tem:rdum md giltly npply tractiolr to but nor through rire extenral os ofrlte cen-rx The
Howevel in a:rnall perceltag,e ofcases one or niote *f ,a st arghtm ,lte carrcal coal. \\,lhere avaiiable ald molerrrort 'l rll ohsi util..E rhe carnula if rt
the il;lloi.:urg coui:Lce,lol: irLty ccalll dui:;g ol ati{
?-.j." "'f7 clinically r 'rorurltie, atruunc tillaaula sr ring <1oes rot d, 1:ress the 1 al-ie buftot(S) ard remole
procedures: uterille or cs'ical iujtq4perfomtisn. peh-rc 6t-s forceps ro'y br u5ad to rrininizr cenrcal tears btrt
ruay shp o T thc' cen'rx uore easillr if srroug tractiot
ihe.:cuir-rle ;i.-iu:ire iii.iii.. i.i!r:i: (..i1= io i.,ii'!!.1!l
coltauuilatro! .{lteuatn ell', remo\-e the ctulnula
rnfectiorL r-agal reactiol. inconrplete e1:acuatlorl or
. rs applied without drpressirrg tile bumons Remor,e the
acrrte henatometra. Sorue of these condrtiorrs car lead Rrrh the br*ton(s) dourr and forrvard (siuultar*ously
for rhe Ipas l{V.A Plus) urtrl vcru teel dren lmk. (1) . frltrod[ce trssuewrth ;terrle ibrceps. Reestabhsh vilclrruu l1]
io s--corrdary rufertilrty. other seriou injrry or death. rhe cmrula ge0tly tlrough thr cen'ica1 the aspfatoi. relnleft the camrrla rrsrrrg no torrrh
. Create a vacuu Lry prrlling the plurger back rnrtil os irtouttrne caTity. Altenrately olc\,e the
rhe techuque and clutiltre the procedrue rf rec<ssu\r
th.' phrnger uurs slap out &rd catch oo the rurde caruula sLrrrly irlto dfe $tsjfie carity rmtil rt touclrrs
srdr's of tlre cylirtler base (?) Both plurger zurns the fturdrB thirr Nrtlrtlmrr rt slrehtly Rotatrno the
munla u',th gmtle pressrue oftet lrlps to ease CAUTION: |Is6 1ry ro mdog mqrlae [y p666g
mu',t be ftr1ly extended to the sities ald srcued theplmga bact ido ee cylindd
over thr edge5 ofdre cylinder Iucorect peirioning 1[Sertlo11-
CAUTION: Do not pcrfmm *erir asfirdimnmmre
of tlx mrs could atrlorv them to slip back usrde
mticn'ntil flrc sirardlmitior of &e uterN and Note: For endoure trral biopsy ruing dre -lnur For ulerile evacrratrol rvhen the ute^r! i: unpra*.
the cyhnder- possrbly itrJectlflg tlrr conteuts ofthe camula. d.:tonine dre uterite depth by tbe lines
mvx hru bca dttumired txge fitnoids c dum asprrator back ulto tlre uterus Ncver grasp the
[-irhdraq. rlte cemla fi-ofl1 the urenrs atcl drpress
emli6 my sake it diffclrhtu &*mirc An sire of rrsrble cn ihe cmula- Thr lire nmrest the tlF of rhe the lah'r brutols. Dilcourrcct tlrr carunrlil frou the
lllc stau ad H. to psfttrm fuFfr{erim
d5p,ratq Ly llrr Fllulscr turrr5. caimrila is lcfl &om dle tip. and the foilorrurg lues a:pirator lJtenntir.ely- lvirhdras the czuuxrla ard
incfudirg'tr"i* mcrulim . Chr:ck for racuul retentior before each use by ile at lcD ilterrals. Aftr measrring the uterile aspu-ator logetha- rvrthorrt depressrug t5.. bufto[r.
lenrng tbe aspiraror sit for se',.aal morrtes after size, qitlxrarv the camula slightly. The srgns !ir,ted belo*' rtrdicate that the ute.mr l!
establishmg a lacurul Thsr release the brrtton(s) Attach the caurula (rvith adapter ifreqlrired) to the eElpty:
A nrsh of nr into the cspir-ator should bc hcarcl. prepared aipimtu (racurun established) by grasping
CAUIION: U* a.o'!r sia appropridetoficriz indicatug drat a r-acurrm rva: retarned.
or prr:k fom rlrthotrt Ir:srn i: seert pasrrle
the caruula 6ruiy at tbe bffie $'ith one lund- holdurg -rrd
tlrroug)r the cutrla. and
offt* utsus ed M of cerviel tlilerim yesa* . If tle nrsh 1t steady. Malie srre that the cmrula dms not fi1oar
Usmg a emlac ttrzt istno qmll ffiyKilt m ret sed of air is not heard. rmror.e the collar stop. gfltty lrDsatlon
f,onrnrd ir,to the utenrs as you attach the asprrator rs felt a:; the canmrla passes or.er
tisse rloss ofstiro- rvrthdrau. the plmger ald check tlat the phurger -a the stuihce of the elaclnted urenr:: ald
O-rng is .free of, dunage and foreigl bodies. propedy \liith the c ther hurd. bold thr aspirator by tbe vah'e
lubricated aad proprly lrcsitioled ir1 the EFNv€- body. Ge r.Jy rotate the aspimtor and push cffilula utfl5 coiltiacts arouncl (grrps) tir caurrla:
1.ib rergc of sggsbd mulrc six rdatiw to uttric bire il fu:ily, trvisting sliglrtly iftecessuy. -lhl-
siaisufollm: ;Uso rnalie srue dre c1'lilder is furnly placecl rn the md the patient aotes pam as tlti utenrs cortract.j.
1'ah,e. Thfll create a \.acuutl tu1d lest rt agaitr. If Note: As m altm{e med}od. the croula can lx
Uhincsiali!{F CtrEdESiE lacrqut is still trot retarrld discro-d aud use anorlrr artached t : dre aspirator ptor to ilse.rtion tlmrgh the Note: For utlourerrial bropsy, the nstrouerlr (ae
e