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  • DOH-Reproductive Health ASC-LTO-At Checklist Repdroductivehealth 1262015rev1

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    al gul
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    The document is a checklist from the Republic of the Philippines Department of Health of equipment and instruments required for various reproductive health ambulatory surgeries. It lists 5 procedures - bilateral tubal ligation, polypectomy, cervical/vulvar biopsy, endometrial biopsy, and no-scalpel vasectomy - and the minimum equipment needed for each, including forceps, retractors, sutures, and speculums. Facilities must check off items as available and compliant or not compliant.

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    DOH Philippines

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    The document is a checklist from the Republic of the Philippines Department of Health of equipment and instruments required for various reproductive health ambulatory surgeries. It lists 5 procedures - bilateral tubal ligation, polypectomy, cervical/vulvar biopsy, endometrial biopsy, and no-scalpel vasectomy - and the minimum equipment needed for each, including forceps, retractors, sutures, and speculums. Facilities must check off items as available and compliant or not compliant.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    156 views1 page

    DOH-Reproductive Health ASC-LTO-At Checklist Repdroductivehealth 1262015rev1

    Uploaded by

    al gul
    The document is a checklist from the Republic of the Philippines Department of Health of equipment and instruments required for various reproductive health ambulatory surgeries. It lists 5 procedures - bilateral tubal ligation, polypectomy, cervical/vulvar biopsy, endometrial biopsy, and no-scalpel vasectomy - and the minimum equipment needed for each, including forceps, retractors, sutures, and speculums. Facilities must check off items as available and compliant or not compliant.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    of 1

    Republic of the Philippines

    Department of Health
    HEALTH FACILITIES AND SERVICES REGULATORY BUREAU

    Checklist of Requirements on Equipment/Instruments for


    Reproductive Health Ambulatory Surgery

    The following equipment/instruments shall be required for the specified procedure. Place a check (/) if the ASC
    is compliant and x mark (X) if not compliant.

    PROCEDURE AVAILABILITY ADDITIONAL COMPLIANCE REMARKS


    (/ if available) EQUIPMENT/INSTRUMENTS
    1. Bilateral Tubal Ligation Minilaparotomy set
    2. Polypectomy • Blade handles
    3. Cervical/Vulvar Biopsy • Babcock forceps (1)
    • Kelly forceps, straight, long
    4. Endometrial Biopsy
    (4)
    • Kelly forceps, curved (2)
    • Tissue forceps (2)
    • Needle holder (1)
    • Apelo retractors (1 pair)
    • Mayo (1)
    • Metzenbaum (1)
    • Towel clips (5)
    Vaginal speculum

    5. No-Scalpel Vasectomy Suture material (surgical silk


    2-O)
    Vas fixing or ringed forceps
    Vas dissecting forceps

    DOH-ASC-LTO-AT Checklist RH
    Revision:01
    01/26/2015
    Page 1 of 1

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