Consent form |
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For explaining the procedure, risks, and benefits to the patient and getting their permission to proceed. |
Timeout Sheet |
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A checklist for doing timout. |
Chucks pad |
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For placing used items during the procedure. |
Lubricant |
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Water based. Applied to the speculum prior to insertion. |
Wash basin |
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Fill with warm water and set the unopened speculum inside. Warm speculums improve patient comfort. |
Speculum |
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A hinged instrument used to visualize the cervix. Warmed up and white-colored speculums are more tolerable. |
Fox Swab |
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Cotton-tipped swabs for removing mucus or blood, gently repositioning the cervix, and holding pressure on the puncture sites on the cervix after the tenaculum is removed. |
Sterile Gloves |
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Sterilized gloves for handling anything that crosses the cervical os. Get the appropriate size for the provider. |
Ringed Forceps |
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For grasping the povidone-iodine swabs for cleaning the cervix. Also used for removing the IUD if there's a problem after insertion. |
Povidone-Iodine Swabs |
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Swabs for cleaning the cervix before inserting the IUD. Also called Betadine swabs. |
Tenaculum |
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A sharp, hooked instrument used to grasp and stabilize the cervix during IUD insertion. |
Pipelle Endometrial Sampler |

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A thin flexible tube with markings for measuring the size of the uterus. |
Flexible Cervical Dilator |

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A mildly flexible plastic that tapers to a rounded point. For dilating the cervix. |
Mirena |
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Ordered by the provider and picked up by the technician at the pharmacy. |
Long Metz Scissors |
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Scissors with long handles for trimming the IUD strings after insertion. |
Hand Wipe |
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For cleaning hands and/or vulva after the procedure. |
Panty liner |
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To be given to the patient after the procedure in case of spotting. |
Menstrual Heating Pad |
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A pad that heats as soon as the package is opened. Applied to lower abdominal area. |