Session IV A, Slide #1

Contraceptive Implants

Session IV A: One-Rod Implant Insertion

Session IV A, Slide #2

One-Rod Implant Insertion: Required Equipment

• An examination table

• Sterile surgical drapes (optional) and gloves

• Antiseptic solution

• Local anesthetic, needles, and syringe

• Implanon applicator

• Skin closure, sterile gauze, and compresses

Session IV A, Slide #3

Implanon Applicator

Session IV A, Slide #4

Implanon Insertion: Step 1

• Have the client lie on her back with the arm that she doesn’t normally use flexed at the elbow and externally rotated.

• Implanon should be inserted sub-dermally just under the skin.

Session IV A, Slide #5

Implanon Insertion: Step 2

• Remove the sterile disposable applicator carrying Implanon from the blister pack.

• While keeping the shield on the needle, visually verify the presence of the implant, seen as a white body inside the needle-tip.*

• Following visual confirmation, the implant should be lowered back into the needle.

*If the implant is not seen, tap the top of the needle shield against a firm surface to bring the implant into the needle tip.

Session IV A, Slide #6

Implanon Insertion: Step 3

• Mark the insertion site with a marker.

• Make 2 marks:

– First, mark the spot where the rod will be inserted.

– Second, mark a spot a few centimeters proximal to the first mark. This second mark will later serve as a direction guide during insertion.

Session IV A, Slide #7

Implanon Insertion: Step 4

• Clean the client’s upper arm with antiseptic solution. Frame the insertion area with a drape that has an opening (optional).

• Anesthetize the insertion area with anesthetic spray or by injecting 2 cc of 1% lidocaine just under the skin along the planned insertion tunnel).

Session IV A, Slide #8

Implanon Insertion: Step 5

• Remove the needle shield.

• Stretch the skin around the insertion site with thumb and index finger.

Session IV A, Slide #9

Implanon Insertion: Step 6

• Insert the tip of the needle, at about a 20 degree angle.

Session IV A, Slide #10

Implanon Insertion: Step 7

• Release the skin.

• Lower the applicator to a horizontal position.

Session IV A, Slide #11

Implanon Insertion: Step 8

• Lift the skin with the tip of the needle, keeping the needle in the subdermal connective tissue.

• While lifting the skin, gently insert the entire needle. Keep the applicator parallel to the surface of the skin.

Session IV A, Slide #12

Implanon Insertion: Step 9

• Break the seal of the applicator.

Session IV A, Slide #13

Implanon Insertion: Step 10

• Turn the rounded end of the obturator a quarter turn, about 90 degrees.

Session IV A, Slide #14

Implanon Insertion: Step 11

• Hold the obturator against the clients’ arm with one hand. With your other hand, slowly draw the needle out of the arm.

• Never push against the obturator.

Session IV A, Slide #15

Implanon Insertion: Step 12

• Check the needle to make sure the implant is absent.

• After retraction of the cannula, the grooved tip of the obturator should be visible.

Session IV A, Slide #16

Implanon Insertion: Step 13

• Verify the presence of the implant by palpating the site.

• Apply a sterile gauze and wrap the arm with a pressure bandage.

• Before the client is discharged, observe her for a few minutes for signs of bleeding from the insertion site.

• Fill out the user card and give it to the client.

• Review post-insertion instructions and other key messages.

• Dispose of the applicator and syringe properly.