Dilation & Curettage Procedure

BACK TABLE

  • Deaver- Retract down vaginal wall

  • Open ended speculum/Peterson speculum/Graves speculum-self retaining you can tighten it to retract vaginal wall

  • Vaginal sound/uterine sound to measure the depth

  • Long alice-grasp cervix and bring it closer to surface (Nice doctor)

  • Single tooth tenaculum/Schroeder-grasp cervix and bring it closer to surface (Barbaric)

  • Uterine dilators-different numbers “low number down” make sure lower number and higher number are in the same direction

  • Red Robinson

  • Uterine curette to integrate the line with the uterus (smallest to largest) give a little space so doctor can grab

  • Sponge sticks-5 things medication, prepping, blunt dissection, hemostasis, application-Fold in thirds. thirds and then half

  • Backhous

  • Edna

  • Straight and curved mosquitos

  • Hemostats because they’re gonna mark stitches

  • Randall stone “Polyp forcep”

  • Single tooth

  • NOBLE-Curved mayo for heavier dissection-beveled/thicker will cut through tissue easily

  • Curved mets

  • Jorgensons-used to cut ligaments/deeper tissue

  • Allis

  • Allis Adare (thicker at the end) used for vaginal tissue to approximate

  • Pratts/Tea-clamps used same ways as allis adares

  • Bozeman “goofy” used to grab tissue, polyps

  • Balentines-longitudinal

  • Haney hysterectomy clamps

  • Double tooth-hold uterus in place

  • Curved foresters

  • Jackson retractor

  • Haney retractors

  • Russians-nontraumatic/ will hold things that slip like uterus

PREP

  • Prepping-pelvic area first, down vaginally all the way to cervix and back, then anally wipe→kick bucket if nurse tries to hand it back to you do not take it, its contaminated

BASIN ORDER

  • Botton drape, 2 towels, 2 leggings

ANTICIPATION

  • Red robinson to drain the bladder

  • TIME OUT

  • Deaver

  • Heavy weight

  • Need to grab cervix→long allis

  • Dilate the cervix “low number down”→put them off to the side

  • Might get asked for biggest dilator in instrument set→biggest curette→Polyp forcep (looks like randall stone) or boseman→Telfa ready for ENDOMETRIAL CURETTINGS→PASS TO NURSE

  • When they get in, they’re gonna scrape the uterine lining→Uterine curette surgeon will ask for a specific size (ex:medium sized straight”)

  • Spoon

  • Have telfa ready for specimen

  • ENDOMETRIAL CURETTINGS-Inside of uterine lining

  • Pass to nurse and verbally say “endometrial curettings”

  • Grab sponge stick to hold pressure→COUN

  • T

  • COUNT→ Raytecs on field→nurse:”need to see it when it comes out”→backtable→circulator count

  • If patient is bleeding→Kelly

SUTURE

  • Add suture to count board

  • Hand curved out

  • Straight mosquito

  • Suture→mosquito

  • Long sponge stick

  • Hold pressure→COUNT

  • Raytecs→1 in pt circulator:”ill see it when it comes out”

  • Sutures