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SECTION "R" PAGES
Pg. R-001 Pg. R-002 Pg. R-003 Pg. R-004 Pg. R-005 Pg. R-006 Pg. R-007 Pg. R-008
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 Section R: Page 002 PHYSICIAN INDUSTRIES CREATE A KIT
EPIDURAL NEEDLES
17G x 3-1/2"
18G x 3-1/2"
18G x 6"
20G x 2-1/2"
20G x 3-1/2"
22G x 3-1/2"
Removable Wing
Fixed Wing
Hustead
Metal Hub
Plastic Stylet
Metal Stylet
LOSS FOF RESISTANCE SYRINGES
Plastic Syringe 7cc LL
Plastic Syringe 7cc LS
Glass Syringe 5cc LL
Glass Syringe 5cc Ls
Other________________
SYRINGES
Syringe 3cc LL
Syringe 3cc LS
Syringe 5cc LL
Syringe 5cc LS
Syringe 10cc LL
Syringe 10cc LS
Syringe 20cc LS
Syringe 20cc LL
Syringe 1cc LS
Other________________
NEEDLES
Needle 18G x 1-1/2" (Pink)
Filter Needle 19G x 1-1/2"
(Clear)
Needle 20G x 1-1/2" (Blue)
Needle 21G x 1-1/2" (Green)
Needle 22G x 1-1/2" (Black)
Needle 25G x 5/8" (Blue)
Needle 27G x 1/4" (Gray)
Filter Straw
Other______________________
SPINAL NEEDLES
18G x 3-1/2"
20G x 3-1/2"
22G x 3-1/2"
22G x 5"
22G x 6"
22G x 7"
22G x 8"
25G x 3-1/2"
Other_____________________
MEDICATIONS
Sodium Chloride 0.9% 10ML Ampule
Lidocaine 1% 5ML Ampule
Lidocaine 1.5% w/ 1:200. EPI Ampule
Lidocaine 1% 30ML Vial Ampule
Lidocaine 2% 10ML Ampule
Bupivicaine ______ % 10ml
Other_____________________
DRAPES AND TOWELS
Fenestrated Drape
Small Fenestrated Drape w/ Tape
Utility Drape w/ Tape
Clear Fenestrated Drape
Absorbent Towel
Blue O.R. Towels
C-ARM Drape
Other_____________________
PREP PRODUCTS
Sponge Applicators
Povidone Iodine 1 oz. Packet
Povidone Iodine Triple Swabs
Pair Surgeon Gloves
Gauze 4" x 4" 8 Ply
Gauze 3" x 3" 12 Ply
Adhesive Bandage
Needle Stick Pad
Other________________
EXTENSION SETS
Extension Set 6" Minibore
Extension Set 12" Minibore
Extension Set 20" Minibore
Other________________
FORMED TRAYS
Large Shallow Prep
Single Shot Tray
Single Deck Epidural Tray
Other________________
CONTINUOUS EPIDURAL
20G Epidural Catheter
Flat Filter
Other________________
MISCELLANEOUS
Skin Marker
Inflation Syringe
NAME: ________________________________
HOSPITAL:________________________________
DEPARTMENT:_______________________________
CITY:_______________________________
ADDRESS:_______________________________
PHONE / FAX:________________________________
PRINT OUT THIS PAGE, FILL IN THE FORM AND FAX TO RICHARD'S MEDICAL
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