Hysteroscopy question

Specialties Operating Room

Published

We have a newer GYN surgeon who requests to have a “hysteroscopy bleed kit” available during his case. The contents are: 

22gauge 3 1/2” spinal needle x 2

med cup

decanter

50 ml bag nacl

16fr 30ml 3 way cath

20units if vasopresin

10ml syringe x 2

Can anyone explain the function and order of this?

 

 

 

 

Specializes in OR, Nursing Professional Development.

Not 100% sure, as the best one to answer (and provide a clearly needed in service for staff!) is the surgeon, but my guess for the foley is that it will be utilized much like a Bakri balloon to be expanded inside the uterus to apply mechanical pressure. Perhaps 3-way to irrigate with saline mixed with the vasopressin? Vasopressin is a vasoconstrictor, so would also be a method to help with bleeding, the two syringes to fill and use for irrigation, decanter to transfer the meds to the sterile field, the med cup to hold the fluids, but out of ideas when it comes to the spinal needles  

 

Thank you! Yes definitely confirming with the surgeon etc. I just didn’t want to look totally clueless 

Specializes in CNOR.

I agree with RoseQueen. At our facility the spinal needle is used for a cervical block. Hope this helps.

Specializes in Operating Room x 38 years.

The items you listed will be used to INJECT a diluted Vasopressin solution into the uterus or near vessels close to the utero-cervical junction. You will dispense the 50 mls saline into the med cup. Then add the 20 units Vasopressin to the saline in the med cup. Other things that might be useful for cervical bleeding would be 2-0 Chromic on a  UROL-5 or UROL-6 needle on a Heaney Needle holder, LONG toothed forceps (11" or longer), Heaney lady partsl retractors, a head light, long duckbill vag speculum and a scrub person who can hold retractors to allow doc to use two hands on the needle holder and pickups.

If you note 300 or more cc blood loss, with doc no further along in controlling the bleed, call your supervisor for some help. The doc will need help, too, but your supervisor in the room can ask them who he would like them to call.

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