‘ProcNexplanonInsert

Nexplanon Insertion Procedure Note

PRE-OP DIAGNOSIS: desired long-term, reversible contraception 
POST-OP DIAGNOSIS: Same 
PROCEDURE: Nexplanon placement 
Performing Physician: Dr. Klubben
Supervising Physician (if applicable): _ 
 
Negative Site (check): [_] Right Arm [_] Left Arm 
Serial # _ 
Sterile Preparation: [_] Betadine [_] Chloraprep 
Expiration Date [_] 
 
Insertion site was selected 8 – 10 cm from medial epicondyle and 3-5 cm posterior to the sulcus. The starting site is marked along with guiding site 5 cm proximally using sterile marker Procedure area was prepped and draped in a sterile fashion. 5 mL of 1% lidocaine without epinephrine used for subcutaneous anesthesia. Anesthesia confirmed. Nexplanon trocar was inserted subcutaneously and then Nexplanon capsule delivered subcutaneously Trocar was removed from the insertion site. Nexplanon capsule was palpated by provider and patient to assure satisfactory placement. 
 
Estimated blood loss of _ mL 
Dressings applied: Adhesive Dressing 
 
Followup: The patient tolerated the procedure well without complications. Standard post-procedure care is explained and return precautions are given.