1 Castroviejo needle holder

2 Right-angle retractors

2 Chops retractors

1 Set of Garrett dilators, nine pieces (sizes 1, 1.5, 2, 2.5, 3, 3.5,

4, 4.5, 5)

String the following instruments from left to right on two 9-inch sponge

sticks or instrument stringer. Then place on top of a rolled Huck towel.

4 9-inch sponge stick

1 Tonsil clamp (bleeder)

1 6.5-inch Crile

1 5.75-inch Crile

1 Baby right-angle clamp

4 Straight mosquitoes

6 Curved mosquitoes

3 Fine curved mosquitoes

2 Tubing clamp with guard

1 Ryder needle holder

1 Webster needle holder

1 Straight mayo scissor

1 5.75-inch Metzenbaum scissor

1 Curved Steven scissor

1 Straight Iris scissor

4 Small towel clips (nonpenetrating)

1 Baby Satinsky clamp

1 Curved bulldog clamp

1 Straight bulldog clamp

1 Disposable ECMO tray (Table 33.2)

ECMO, extracorporeal membrane oxygenation. For information on suture material,

see Appendix B2.

Fig. 33.2. Infant positioned for cannulation with shoulder roll

present and head extended to the left. Position of neck incision is

indicated.

Table 33.2 Contents of Disposable

ECMO Tray

Number Item

2 1-mL syringe

1 20-mL syringe

1 6-mL syringe

1 3-mL syringe

1 Needle adapter

3 Single-cavity tray

2 Gauze packages

1 Betadine ointment

1 Surgical blade no. 15 carbon

2 Semipermeable transparent dressings

1 Handle, suction Frazier, 8 Fr

1 Xylocaine insert

1 Mini yellow vessel loops

1 Hand-control cautery

1 Suture, 4-0 Vicryl

1 Suture, 2-0 silk

1 Suture, 6-0 Prolene

4 Forceps, sponge

1 25-gauge needle

1 NaCl, 5-mL amp

1 3-g foil package of Surgilube

1 Surgical blade, no. 11 carbon

2 Steri-Drapes

2 Connectors, straight 0.25 × 0.25 inch

1 Xylocaine 1%

1 Suction tubing, 3/16 inch × 10 ft

1 Package sterile towels (14)

9. At the point of incision, infiltrate the skin with lidocaine (0.25%, with epinephrine) (Fig. 33.2).

10. Wait at least 3 minutes for anesthesia to be effective.

11. Make a 1- to 2-cm vertical incision over the right sternocleidomastoid muscle, starting approximately 1 cm

above the right clavicular head, using the electrocautery set on cutting current (Fig. 33.3).