Your Full Name: Your Email Address: Facility Name: Zip Code to ship to: Pre-Operation: Additional Notes: Stretcher (Per Patient Load Estimate) Oxygen Flowmeters -Ohio Quick Connect/Disconnect Recommended-(Due to ease of locating parts and/or spare units) Suction Regulators -Choice of Continuous/ Continuous-Variable) Suction Canister -Various Sizes Available- Recommended 1500cc Headwalls - Consisting of both suction, O2 Flow and Suctions Canisters Slide Receptacle for Each Patient Monitor(s)- Either Separate or Multi Parameter. Advise ECG, SPO2, NIBP. Optional: Recorder (Recommended only if Hard Copy Required), CO2, Temperature Mobile Blood Pressure Unit as Back-Up (Inexpensive) Temperature Units - Either w/probe or Tympanic (At least one is Recommended, even if Temperature is Included on Patient Monitor Supply Cart- Usually Stainless Steel, i.e., Lakeside Cart or Similar Overbed Table -Recommended- Qty As Needed Examination/Physicians Stools- Various Styles. Options: Pneumatic, Screw, or Fixed Height Operation. Recommend New Stools for Value/Life Expectancy Surgical Scrub Sink -single, double or triple bay. Infrared or knee operation Surgery: Additional Notes: Surgery Table -Per Surgeon- Optional: Manual or Electric Operation, Armboards, 'Diving Board' (Radiographic), Stirrups, Knee Crutches, Cystoscopy Tray/Catcher, etc. Most popular Cosmetic Table would be Amsco 2080 series Anesthesia Machine – Configured per Surgeon/Anesthesiologist. Recommend North American Drager or Ohmeda. Recommend units with which manifold accepts Desoflurane and Sevoflurane. Anesthesia Cart – Various Styles. Locking Drawers/Compartments a Necessity. Anesthesia Gas Monitor – Various Models Available – To Surgeon/Anesthesiologists Comfort Level for Ease of Use/Necessary Configuration. Recommended: Monitor which is capable of all Five Gases and EtCO2 with External Vapor Trap. Options Include: Agent ID, SAO2(If not Inlcuded on Patient Monitor, See Next). Various Manufacturers. Patient Monitor - Either Separate or Multi-parameter. Advise ECG, SAO2(Unless Preferred on Gas Monitor), NIBP, Recorder. Optional: Temperature Oxygen Flowmeter – Ohio Quick Connect/Disconnect Recommended (Due to ease of locating parts and/or spare units). One Recommended per Surgery Suite. Suction Regulators - Choice of Continuos / Continuos-Variable. Two Recommended per Surgery Suite. Headwalls – Consisting of Suction, O2 Flow and Suction Canister Slide Receptacle. Ohio Quick Connect/Disconnect Receptacles Recommended. Two Such Headwalls Recommended, one utilized by Anesthesia Unit, the other utilized during procedures. Optional: Single Headwall Receptacle for only Suction in Addition to the Two Recommended Previously. Suction Stands – Includes ability to hold up to four Suction Canisters of Varying Sizes. Only Recommended if procedures will be performed in which high volumes of fluid are expected. Mayo/Instrument Stand – Various Sizes and Styles Available X-Ray View Boxes – Models Range from Single Box to Bank of 6, Auto Power On, Recessed or Wall Hanging, Various Bulb Quantities for Different Levels or Illumination. Back/Instrument Table – Mobile - Various Sizes Available from 4’ to 6’ long and Widths from 24” to 36”. Optional: Lower Shelf. Supply Cart: Lakeside or Similar ElectroSurgical Unit – Varying Styles and Manufacturers. Dependent on type of Procedures Performed. Varying Power Outputs. Recommended: BiPolar/MonoPolar Operation w/ Foot Pedal Actuation, Cart Surgery Lights – Varying Outputs (Lux) and Configurations. Configurations: Single or Dual Head, Single Reflective or Multi-Bulb, Center Mount 360 Degree Swivel or Track Mounted, Fixed Brightness or Wall Mounted Intensity Control (Usually Installed Pre-Construction) . Sterilizable Handle. Various Manufacturers. Surgeons Stool – Various Styles and Configurations Anesthesiologist Stool – Various Styles and Configurations Suture Stand – Various Sizes - Dependent on Surgeons Preference Kick Buckets w/ Carriage IV/Syringe Pump (please indicate whether or not you will be using Diprovan or any other anesthetic which requires special consideration for pump selection) Liposuction Aspirator Unit (Similar to Miller or Wells-Johnson) Klein Pump Suction Tree (Multiple canister mobile unit) Cosmetic Lasers (per requirements) Optional for Surgery: Additional Notes: Supply Cabinet – Fixed Upright Cabinet, Usually with Glass Door(s) and Stainless Steel Construction. Range in Height from 5’ - 6’, and 24” – 40” Wide. Space available determining Factor. Optional: Locking Doors, Pull Out Writing Surface, Lower Drawers/Cabinets Surgeons Headlamp and Light Source – Various Styles and Manufacturers UPS/Backup Power Supply – Dependent on average run time, amperage and current draw of equipment. Typical units for cosmetic surgery suite average approximately $4,000.00-$5,000.00 (New). Used units occasionally available(must have new batteries). Also Available: , Portable Suction, Jet Ventilators(Per Anesthesia), Tourniquets, Surgical Microscopes, Various Pumps, etc. Post Operation: Additional Notes: Stretchers - Per Patient Load Estimate – Various Styles Oxygen Flowmeters – Ohio Quick Connect/Disconnect Recommended(Due to ease of locating parts and/or spare units) Suction Regulators - Choice of Continuous / Continuous-Variable Suction Canisters – Various Sizes Available – Recommend 1500cc Headwalls – Consisting of Suction, O2 Flow and Suction Canister Slide Receptacle for Each Patient. Patient Monitor(s) – Either Separate or Multi-parameter. Advise ECG, SAO2, NIBP. Optional: Recorder (Recommended only if Hard Copy Required), CO2, Temperature. Mobile Blood Pressure Unit as Back-Up (Inexpensive). Could be Shared with Pre-Op Temperature Units – Either w/ probe or Tympanic (At least one is Recommended, even if Temperature is Included on Patient Monitor.) Supply Cart – Usually Stainless Steel, i.e., Lakeside Cart or Similar Overbed Table(s) – Recommended Oto/Opthalmascope - Recommended Examination Stools – Various Styles. Options: Pneumatic, Screw, or Fixed Height Operation. Recommend New Stools for Value/Life Expectancy. Privacy Screens – Inexpensive – Various Styles Privacy Curtains – Track Mounted – One for Each Patient Area Blanket Warmer - Various Styles and Sizes per Caseload. Gas or Electric(Recommended). EKG Unit – 10/12 Lead. Options: Preview Screen, Full Page or Strip Record, Rhythm Strip, Interpretive/Non Interpretive, Ability to Enter Patient Data (Recommended), Measurements, Battery Backup(Recommended) and Cart (Recommended-Supplied). Patient Warming System: Recommended Bair Hugger or Similar Wheelchair(s) Hospital Bed(s) – If extended stay < 24hrs Sterile Supply: Additional Notes: Sterilizer/Autoclave – Type Dependent on WorkLoad. Various Sizes from 7” Diameter to 36” and Up. Various Options Include: Automatic Door Opener for Drying Cycle, Printer. Larger Units Require Water Supply with Ample Water Pressure, Floor Drain, and Steam Generator. Sterilization Trays – Dependent on Type of Instruments to be Sterilized. Ultrasonic Cleaner - Various Styles and Sizes Dependent on WorkLoad. Options: Heat Wrapping Table – To Tech’s Preferences Other Critical/Equipment: Additional Notes: Crash Cart – Various Styles Half Backboard – Standard and Included on Crash Cart IV Pole – Standard and Included on Crash Cart O2 Tank Holder – Standard and Included on Crash Cart Defibrillator: Various Manufacturers and Options. Recommended: Sync, Recorder and ECG Monitor. Optional: Pacing, Advisory Adapters(AED) Suction: Portable Suction to Be Placed on Crash Cart. Standard Unit, Small, Portable. Double Locking Narcotics Box - Wall Mount or Recessed. Various Sizes Available. Sharps Containers IV Poles – Dependent on Staff’s Requirements IV Pumps - Various Styles – Battery Backup – Optional: Single or Dual Channel, Flow/Rate Adjustments while in Cycle (For Diprovan Administration). Type Dependent on Drug Administered. Fluid Warmer – Used for IV Therapy or Similar – Maintains Fluid at Comfortable Temperature For Patient Supply Equipment: Additional Notes: Mobile Racks for Supplies – Various Sizes and Styles Glove Box Holders Large Suture Cart- For Central Supply Various Small Circulation/Supply Carts-i.e. Lakeside Wall Desks – Pull Down Writing Tablet Instruments: Additional Notes: Must Consult, Various