Material List by Procedure. The following lists are provided to ensure that the correct supplies are in place prior to the procedure.

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1 Material List by Procedure Purpose: Policy: The following lists are provided to ensure that the correct supplies are in place prior to the procedure. Changes to material lists must be approved by the medical director Angio Tray 3. Sterile Gloves ( Physicians Sizes) 4. Femoral Drape 5. Clear 10cc syringes 6. 1 Red (Lidocaine)10 cc syringe Yellow(Contrast) 10 cc syringe 8. 5 Fr or requested or appropriate French size sheath 9. 19ga single NDC (may ask for Micro-or Angio cath) 10. Angio Kit(Flush Kit): Flow switch, high pressure connecting tube included 11. Power Injection Syringe 12. Contrast 13. Bag Decanter 14. Heparinized Saline: (1) 500cc for flushing(angio Kit), (1) on table in large bowl 15. Wires: At Physicians Request 16. Catheters: At Physicians Request (Have Balloons, Stents, Coils available for Invasive Procedure if Needed) Drain Tray (U/S, CT or Flouro) 2. Diamond drape Sterile Ultra sound probe cover if U/S used. 5. Kover Cap if U/S used 6. Sterile Gloves( Physicians Sizes) 7. 1 Red(Lidocaine) 10 cc syringe 8. Angio Kit(Flush Kit) Flow switch, high pressure connecting tube included 9. Bag Decanter 10. (2) 600cc Luer Lock Syringes 11. (1 ) 2-0 Silk Suture 12. Op site bandage if requested 13. (1) Drainage Bag 14. (1) Blunt Needle For chem. 15. Wires- At Physicians Request 16. Drain Cath ( Dawson Mueller) or Physicians Request 17. Heparinized Saline: (1) 500cc for flushing(angio Kit), (1) on table in large bowl 18. (1) 3 way Stop Cock(Cook) University Health Shreveport Page 1

2 19. (1) extension Tubing(Hospira) 20. Securement Device(Merit) or Physcians Request 21. Have Contrast Available Aspiration( U/S, CT or Flouro) 1. Biopsy Pack (includes diamond drape) 3. Sterile Gloves(Physicians Sizes) 4. 10cc red syringe(lidocaine) 5. Sterile Ultrasound Probe Cover 6. Diagnostic: Or At the Physicians Request a. Spiral NDC b. Chiba NDC c. Angio cath 16ba long grey one d. YUEH 19 ga 10 cm e. (2) 60 cc leur lock syringe f. Plurovac 7. Therapeutic: Or At the Physicians Request a. Angio Cath 16 ga long gray one b. Yueh NDC 19 ga 10 cm c. Wire 0.35 floppy J d. 10 fr drain cath e. Could use cath as large as 20 fr f. Fluid collections bags g. Could use large base 3 way step cock and drain bag BIOPSY( U/S, CT or Flouro) 1. Biopsy Pack (will include diamond drape). 3. Sterile Gloves (Physicians Sizes) 4. Ultra Sound probe Cover 5. Red 10cc syringe 6. For percutaneous (FNA) a. 22 & 25 gr. Spiral NDC s multi 7. Core Biopsy a. Automactic 18ga cook (or NDC ) 8. Chest Bx fr. or 8fr. Cath for pneumothera 2. Pleurovac 0 or Heimlick valve University Health Shreveport Page 2

3 Materials for Arterial or Venous Access FEMORAL ACCESS: Ultrasound May be Used) Needles: Singlewall Seldinger or Micro puncture Set or sheathed gauge. AXILLARY JUGULAR/SUBCLAVIAN ACCESS Access: Micro puncture set (Cook) A Bentson and a 3 mm J wire should also be available for access. Luer-lock syringe should be used when ever possible to insure positive connection between catheter and syringe. Materials for Neuro (4 Vessel/Embolization/Stenting) Angio Pack Femoral Drape Wires: Physicians Request Catheter: Physicians Request 4-Clear( Hep saline) 10cc syringes 1 Red (Lidocaine)10 cc syringe 4- yellow(contrast) 10 cc syringe 5 fr sheath or as Requested by Physician 19ga single NDC (may ask for Micro-or Angio cath) Flush Bag( Angio Kit) -Flow switch, high pressure connecting tube included. 2 to 4 500ml Heparinized Saline bags 2-4 Pressure bags/if needed Fluid administration Tubing(Merit) Power injection Syringe. Bag Decanter Contrast: Visapaque continued: University Health Shreveport Page 3

4 For Neuro Embolization have Ready: Fluid administration Set(Merit) Yellow 3cc and 1cc Syringes 2-4 Pressure Bags ( Central) Touy Valves-Copilot(Guidant), Guardian(Micron Filters) Micro Catheters: Physicians Request Micro Wires: Physicians Request Coils, Stents, Balloons, Particles, Glue: Physicians Request Closure Device: Physicians Request RFA/CYRO/ALCOHOL ABLATION(CT) 3. If Cyro(Gas Tanks- Machine- Probes/Tubing-Warm Saline(500ml) 4. If RFA ( Probes, Machine) 5. If Alcohol( Needles, Alcohol) 6. Sterile Gloves( Physicians Sizes) 7. 1 Red 10 cc syringe 8. Angio Kit(Flush Kit) Flow switch, high pressure connecting tube included 9. Bag Decanter 10. (2) 600cc Luer Lock Syringes 11. Normal Saline: (1) 500cc for flushing(angio Kit), (1) on table in large bowl CHEMO ABLATION(Flouro/Neuro Room(Eye Wash) 3. Embolization Beads/appropriate sizes0 4. Chemo Agent( Make sure on hand for procedure) 5. Chemo Disposal Barrel and Bags Available. 6. Eye Protection 7. Sterile Gloves ( Physicians Sizes) 8. Femoral Drape 9. Clear 10cc syringes Red 10 cc syringe yellow 10 cc syringe fr sheath ga single NDC (may ask for Micro-or Angio cath) 14. Angio Kit(Flush Kit): Flow switch, high pressure connecting tube included University Health Shreveport Page 4

5 15. Power Injection Syringe 16. Contrast 17. Bag Decanter 18. Heparinized Saline: (1) 500cc for flushing(angio Kit), (1) on table in large bowl 19. Wires: At Physicians Request 20. Catheters: At Physicians Request Reviewed: 11/09/2012 Updated: October 2013 University Health Shreveport Page 5

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