1. 1)Sterile procedure for opening 2)Instruments 3)Organization 4)Secondary Pack Revised 7/12/01

2. Start with a Sterile Pack

3. Notice the edges, pull top edge away from you first, then, pull nearest edge toward you.

4. Arrangement of Pack Upon Opening -silk ties are taped for organization -Large instruments are “strung” -all tips are protected with tubing -plungers are out of syringes for proper sterilization -Cotton Tips applicators are tied together -plugs are in an eppendorf tube with a gauze stopper

5. Instruments Required for Pack 2 Muscle Needles2 Skin Needles 1 Adson-Brown Forceps1 Rat Tooth Forceps 2 Dumont #7 Forceps2 Graefe Forceps 45 2x2 gauze1 - 18 gauge needle 2 adapter tips1 8” Trochar 4 Curved Mosquito clamps 1 Iris Scissor 1 Nursing Suture Scissor20 Cotton Tip Applicator 1 Needle driver – scissor combination instrument 1 Straight Mosquito with tubing on ends for occluding 2 - 1cc syringes (used to flush catheters) 1 - 3cc syringe (used to draw up stock Saline for entire procedure) 10 plugs for catheters, stored in an eppendorf tube with gauze plug 8 pieces of 3-0 silk ties, cut to approximately 10”, this includes ties for muscle suture and will allow two procedures with both A.V. Lines

6. Arrangement of Instruments for Surgery -silk suture on muscle needle had been pre-swaged before autoclaving and is now ready to use -Instruments are in order of procedure from left to right -skin needles are wrapped in piece of gauze

7. Surgical Station -Betadine, Alcohol, 2x2 gauze, WhiteTape, Super Glue, Antibiotic Ointment

8. Secondary Pack -Purpose, to have the minimal amount of sterile equipment so that only the tips of the instruments need to be dry sterilized -Notice the silk suture for the muscle are already pre-swaged -there are ties, plugs, syringes, 2x2’s -most importantly, a sterile trochar