Needle Localizations

Consent form (and Time Out Sheet for HF only)

  • Verify patient name, DOB, and surgery site.
  • Explain procedure to patient.
  • Ask about allergies.
  • Ask about bleeding (aspirin, NSAIDS, vit. E)

Review images.

  • Check with radiologist for approach.
  • (CC-superior lesion)
  • (FB- inferior lesion)
  • (LM-lateral lesion)
  • (ML-medial lesion)
  • Check with radiologist for needle length required.

No scouts usually necessary.

  • May be for patient with outside study.
  • Most of our diagnostic work up include a 90, so isn’t necessary to repeat.

Specimen Imaging.

Phone numbers to the OR are usually found on the lab requisition.

If not on the lab req., phone numbers to the OR’s, are posted on the phone lists in each

tech station.

SHIC

SHDB surgery: 474-417__ (the last digit is the OR room # listed on the path sheet)

(call 474-4450 if just checking on anticipated time of arrival of the specimen)

RWC surgery: 459-1658

SHMC main OR: 474-3232

VC

VOSC: VH Auto Dial +5488 or 922-0362

VHMC main OR: VH Auto Dial +5484 or 924-6650

HF

HF Hosp OR: 22641 Room 1

22642 Room 2

22643 Room 3

22644 Room 4

22645 Room 5

22646 Room 6

ASC (AmbulatorySurgeryCenter

22842 Room 7

22843 Room 8

22844 Room 9

22845 Room 10

Supplies

  • Localization tray (may be set up, up to 24 hours prior to procedure but don’t drop needle until rad specifies and patient has arrived)
  • Supplies for trays are located in……
  • Stereo room or room 1 or supply closet at SHIC
  • Exam Room 2 at HF
  • Exam Room 2 &3 at VC
  • Localization chair with pillow and a couple of blankets.
  • Chair at SHIC is in small closet outside stereo room.
  • Chair at HF is in little front office.
  • Chair at VC is in dressing room 4.
  • Washcloths and towels available.
  • Ammonia Inhalant
  • Drug Box
  • Nurses phone number.
  • 37985 HF
  • 3832 SHIC
  • 6232 VC
  • Sterile barrier
  • 5 cc syringe
  • xylocaine- 4 –4.5 cc’s
  • neut-- .5 to 1 cc.
  • Contrast (dependant on surgeon) see list in mamm rooms.
  • Conray –1 cc in a tuberculin syringe.
  • Charcoal—1 cc in a tuberculin syringe
  • Methylene blue—1 cc in a tuberculin syringe.
  • Sterile 4 x 4’s.
  • 27 and 30 gauge needles. 1- 1 ½ inches.
  • Localization needle (length determined by rad)
  • Have various lengths available.
  • Have radiologists gown and sterile gloves available.

Begin procedure.

  • Change compression from automatic to manual.
  • Let rad know that you are ready.
  • Have rad sign the consent form that the patient and yourself (witness) have already signed.
  • Once the rad is ready
  • Take image, in position specified by radiologist, with the open grid paddle.
  • Call radiologist to come in once you have the grid image w/lesion in window.
  • Clean area within the window, with betadine (green soap for those with iodine allergy) while waiting for rad to come in.
  • Take final images CC and LM (or ML) wait for the Dr. to okay before sending the patient to surgery. Get completed paperwork to rad as soon as possible (clean up room after you get paperwork to rad or ask some one to do one or the other for you.)

Helpful Hints.

  • Have your views chosen ahead of time.
  • Use full resolution, magnification and window/level to optimize for better

visualization.

  • You may need to use a manual technique---base this on what was used on

original images.

  • Move cross hairs out the way before taking exposures.
  • Previous images can be retrieved and available but not always necessary.
  • May be helpful for difficult to see lesions/calcs.
  • Don’t forget to change the compression back to automatic at the end of the exam.