Andre Adianto

18/423064/KU/20267
Group 7
PD Inter 2018
PENUGASAN BCCT IUD INSERTION AND REMOVAL
No Screenshot Steps Explanation
.
1 Preparation  Greeting the patient
and self
introduction
 Counsil the patient
on methods of
contraception and
also screen for
patient’s eligibility
for IUD insertion
 Obtain informed
consent
 Ask the patient to
empty their bladder
and rinse area
around vagina
thoroughly
 Prepare high-level
disinfected (HLD)
instruments on an
HLD tray

2. Physical  Perform aseptic

Examinatio procedure
n Prior to  Check for anemia
IUD signs
Insertion  Perform genitalia
examination
(Inspection)
 If there are no
abnormalities, do
bimanual procedure
  Performs speculum
exam, check for
purulent vaginal or
cervix discharge,
ulcers, lesions

3. State State the result of previous

diagnosis examination and make
decision if IUD can be
inserted or not. If the results
were fine and IUD can be
inserted, then proceed

4. IUD  Prepare the

insertion equipments
 Ask the patient to
lay in lithotomy
position
 Adjust the
gynecological lamp
 Wash hands and use
gloves
 Loads the IUD inside
the sterile package
according to
package
instructions/protoco
l. There are two
methods:
 Loading the IUD
with safe load
 Manual
Procedure
 Prepare the external
genitalia with iodine
soaked cotton
 Cover with sterile
linen
 Prepare and
lubricate speculum
 Insert speculum
using right hand into
the vagina until the
cervix is clearly
seen. Then lock the
speculum
 Swabs cervix and
vagina with
antiseptic at least
twice. Waits for two
minutes if using an
iodophor.
 Gently grasps the
anterior lip of the
cervix with
tenaculum (11-1
o’clock position)
 Sounds uterus using
no touch technique
and mark the
uterine depth
 Sets blue depth
gauge on the loaded
IUD inserter to the
depth of the sound
 Inserts the IUD
using the
 withdrawal
technique
 Cuts strings 3-4 cm
from the cervical
opening then
remove tenaculum
check if there’s
bleeding from
tenaculum wound,
clean it
 Disinfect cervix with
iodine
 Loose the screw,
then remove
speculum slowly
 Place the string in
posterior fornix

5. Post  Dispose used

insertion materials and
place
contaminated
equipments for
later cleaning.
 Explain that the
procedure went
smoothly
 Explain any side
effects or
adverse events
that may
happen
  Discuss what to
do if the patient
experiences any
side effects or
problems.
 Ensure that the
patient fully
understand and
remember the
explanation
 Reassure
patient that she
can always
consult with us
 Plan return visit
in 3 weeks
 Observes the
patient for at
least 15 minutes
before sending
her home.
 Document the
visit by using
clinic guideline
6. IUD  Do counsiling before
Removal removal procedure
 Prepare the
equipments
 Ask the patient to
lay in lithotomy
position
 Adjust the
gynecological lamp
 Wash hands and use
gloves
 Prepare the external
genitalia with iodine
soaked cotton
 Cover with sterile
linen
 Perform Bimanual
exam
 Lubricate and insert
speculum, then lock
the position
 Swab cervix and
 vagina with
antiseptic
 Grasps strings using
narrow forceps,
curved clamp or
ovarian clamp close
to the cervix and
pulls gently but
firmly to remove the
IUD.
 Loose the screw,
then remove
speculum slowly
 Dispose used
materials and place
contaminated
equipments for later
cleaning.
 Explain that the
procedure went
smoothly
 Explain any side
effects or adverse
events that may
happen. Prescribe
antibiotics or
analgesics if needed
 Document the visit
by using clinic
guideline