Uterine evacuation with manual vacuum aspiration ... - CommonHealth

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Tool B-6: MVA Procedure Checklist: Incomplete/Missed Abortion INSTRUCTIONS: Provide a copy to each participant for use during training on pelvic models. Skills Yes No Comments Creates pain management plan Tailors pain management plan with woman according to her needs Discusses sources of pain, options, potential side effects Includes combination of support and pharmacological measures Takes into account woman’s medical and psychological status, dilatation necessary, staff skill, nature of procedure and availability of supplies Prepares the instruments Checks vacuum retention of aspirator Has more than one instrument available Prepares the woman Administers pain medication in timely fashion Asks woman to empty her bladder Asks what supportive measures she would like and provides them Asks for permission to start Puts on barriers and washes hands Performs pelvic exam to confirm assessment findings Warms and inserts speculum gently Removes foreign bodies in os; refers if bowel present Performs cervical antiseptic prep Follows No-Touch Technique Uses antiseptic sponges to clean os and, if desired, vagina Administers paracervical block Uses less than 200mg lidocaine Aspirates before injecting 1–2mL at tenaculum site Places tenaculum Applies slight traction to expose tissue transition Slowly injects 2–5mL lidocaine to 1–1.5 inches at 3,5,7 and 9 o’clock Dilates cervix if needed Inserts cannula Applies gentle traction to cervix Rotates cannula while gently applying pressure Inserts cannula to just past internal os OR to fundus and pulls back Suctions uterine contents Holds tenaculum and end of cannula in one hand UTERINE EVACUATION WITH MVA: A TRAINING MANUAL FOR CONDUCTING SHORT COURSES Page 16
Attaches charged aspirator Releases buttons to start vacuum Rotates cannula 180 degrees each direction Uses an ―in and out‖ motion Does not withdraw aperture beyond os Uses gentle operative technique Uses positive, respectful, supportive reassurance Stops when pink foam without tissue passes, gritty sensation is felt, uterus contracts around cannula and uterine cramping increases Removes the instrument Is ready to evacuate again after inspecting tissue if needed Inspects tissue Empties aspirator into container Looks for products of conception (POC) Evaluates amount based on estimated gestation Determines all POC have been removed Completes remaining steps: Wipes cervix to assess bleeding Considers if pelvic exam is advisable Reassures woman that procedure is finished Performs post-procedure care Processes instruments Removes barriers and washes hands Ensures woman is escorted to recovery area Resolves technical problems that arise UTERINE EVACUATION WITH MVA: A TRAINING MANUAL FOR CONDUCTING SHORT COURSES Page 17
Page 1 and 2: Uterine Evacuation with Manual Vacu
Page 3 and 4: Manual Vacuum Aspiration (MVA) Each
Page 5 and 6: The Courses The three courses vary
Page 7 and 8: Ipas policy/guidelines on clinical
Page 9 and 10: the trainer/presenter not wish to i
Page 11 and 12: MVA Course 301: Supervised Clinical
Page 13: Tools
Page 16 and 17: Tool A-1: MVA 101 Course Overview (
Page 18 and 19: Tool A-3: MVA 101 Recommended Mater
Page 20 and 21: Tool A-5: MVA 101 Course Evaluation
Page 22 and 23: Tool A-6: MVA 101 Certificate Templ
Page 24 and 25: B) MVA Course 201 The materials pri
Page 26 and 27: Tool B-3: MVA 201 Sample Materials
Page 28 and 29: Tool B-4 MVA 201 Sample Planning Ch
Page 32 and 33: Tool B-7: MVA 201 Sample Learning A
Page 34 and 35: 13. Paracervical block by itself is
Page 36 and 37: 4. Now that I have completed this c
Page 38 and 39: Tool B-10: Information on Instrumen
Page 40 and 41: Tool C-2: MVA 301 Sample Agenda for
Page 42 and 43: 1 per participant plus extras Proce
Page 44 and 45: 5 weeks prior Advertise, invite par
Page 46 and 47: ❑ If the learners will be divided
Page 48 and 49: Holds tenaculum and end of cannula
Page 50 and 51: Clinical Skills Evaluation UTERINE
Page 52 and 53: Sample Learning Assessment Tool for
Page 54 and 55: Tool C-8: MVA 301 Course Evaluation
Page 56 and 57: Tool C-9: MVA 301 Certificate Templ
Page 60: E-09-MVA-008 Rev. 0 12/2009 MVASRTC

Uterine evacuation with manual vacuum aspiration ... - CommonHealth

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