Naltrexone Pellet Injection Procedure

1. Naloxone Challenge - 1 mg IV and observe for signs of withdrawal
2. Administer prophylactic antibiotic
3. Local Anesthesia
1. Wash hands with antimicrobial soap
2. Apply antimicrobial handcream
3. Apply non-sterile gloves
4. Cleanse skin with antimicrobial wipe
5. Cleanse skin with isopropyl alcohol
6. Inject area with 2% lidocaine with epinephrine and bicarbonate buffer in 5cc syringe with a 25g x ½" needle under ~ 1" of skin
4. Pellet insertion
1. Apply antimicrobial handcream
2. Apply non-sterile gloves
3. Open packet of sterile supplies
4. Prepare Area with 3 sterile betadine swabs
5. Apply sterile gloves
6. Apply sterile drapes
7. Make ~1cm incision with sterile #15 scalpel
8. Inject 5cc of 2% lidocaine with epinephrine and bicarbonate buffer in 5cc syringe with a 18g x 1 ½" needle through the wound in a medial direction anesthetizing a tract through which to insert the pellet insertion device.
9. Insert sterile pellet within sterile insertion device pellet
10. Close wound with staples from disposable stapler
5. Clean and dress wound
6. Provide wound care instruction sheet to patient