Contraceptive implant procedure

CONTRACEPTIVE IMPLANT PROCEDURE [+] yes, present, positive [-] no, absent, negative [~] equivocal [\] not applicable, not performed [?] unknown, unsure, unavailable { } annotation, comment Contraindications: [-] history of thrombosis or thromboembolic disorders [-] hepatic tumour [-] active liver disease [-] undiagnosed abnormal genital bleeding [-] known or suspected breast cancer, history of breast cancer, or other progestin-sensitive cancer. allergic to a component of the implant. Patient information: 1. Pearl Index (failure rate) >0.5 pregnancies per 100 woman-years of use. 2. Effective for 3 years. 3. Women may have longer or shorter duration or menstrual bleeding, or no bleeding at all. The most common side effect is unscheduled, or irregular, uterine bleeding, which may or may not decrease with continued use. 4. Other adverse reactions include: headache, weight gain, acne, breast tenderness, emotional lability, and abdominal pain. Pre-insertion pregnancy check: At least 1 must be [+] [-] No intercourse since last normal menses. [-] Correctly and consistently using a reliable method of contraception. [-] Within 7 days from the first day of menstrual bleeding. [-] Within 4 weeks postpartum (for non-lactating patients). [-] Within the first 7 days post-abortion or miscarriage. [-] Fully or nearly fully breastfeeding, amenorrhoeic, and less than 6 months postpartum. [-] Pregnancy test at least two weeks after the last episode of sex. Procedure: 1. Insertion side (upper arm): Left**Right 2. Insertion site: 8-10 cm proximal to the medial epicondyle of the humerus and 2-3 cm posterior to the sulcus between the biceps and triceps muscles. 3. Anaesthesia: Intradermal injection of 1-2 mL, 1% lidocaine into the insertion site and insertion path. 4. Implant inserted into the superficial subdermis. 5. Implant placement confirmed by palpation by operator and patient. 6. Insertion site is closed with skin closure and the implant site covered by a gentle pressure bandage. Aftercare advice: 1. Use simple analgesia for pain, if required. 2. Remove the pressure bandage after 24 hours. 3. Abstinence or back-up contraception is suggested for the first 7 days after insertion if the implant is inserted >5 days since the beginning of the patient's last menstrual period. 4. Seek medical advice if they develop pain, discharge, or swelling at the insertion site; fever; or other concerns.

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