Use of a Tenaculum
Purpose of a Tenaculum
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Stabilize the cervix to allow passage of sound and IUD through the os
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Straighten any irregularities in the cervical canal
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Straighten uterine curvatures or flexion
To Place
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Dominant hand in “palm-up” position
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Thumb in one ring
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Middle or ring finger in the other ring
Choose Site for Placement
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Anterior lip
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Posterior lip
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Typically a horizontal bite, some prefer vertical
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Do not occlude os!
Size of Bite
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1-1.5 cm wide
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1 cm deep
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Not too shallow- may tear through
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Not too deep- unnecessary
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Do not occlude os!
Closing Ratchet
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Once the teeth are in contact with the cervix, press into the tissue
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Close the ratchet only 1-2 clicks
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Close the ratchet silently
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Once the ratchet is closed, test your application gently to be sure it is secure
Alternatives
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Squeeze teeth together EXCEEDINGLY slowly
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Have patient cough at application (hold onto speculum!)
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1 cc Local anesthetic to tenaculum site
Use When Sounding
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Change hands; hold the tenaculum with the non-dominant hand while sounding and for IUD placement
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OK to let tenaculum lay on speculum when picking up the sound or IUD
Tenaculum Hand Position While Sounding and for IUD Placement
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Thumb on one side of ratchet and fingers on the other
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Avoid the rings
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Avoid inadvertent movements
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USE the tenaculum
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