Injections Flashcards
How to minimise discomfort
Slow bolus
Benefits of low pressure injections
Reduce risk of vascular occlusion
Large bore needles
Increase likelihood of positive flashback
Accomodate lower extrusion pressire
Higher G-prime filler
27G needle due to extrusion force needed
Lower G-prime filler
30G needle
Anatomical Layers
- Skin
- Superficial fat
- Muscles/SMAS
- Deep fat
- Periosteum
Visual cue for needle depth
Intra-dermal - grey of the needle can be seen
Deep dermal - shape of the needle can be seen
Techniques for placing filler
Linear threads
Blanching
Bolus
Fanning
Cross hatching
Serial puncture
Bolus technique common layer
Layer 4 - deep fat
Linear thread common layer
anterograde of retrograde
Layer 2 - superficical fat
Layer 4 - deep fat
Blanching
Multiple small papules with fine bore needle
Tenting skin with needle
Low G prime filler
Perioral, perioribital lines, neck & declolletage, hands & feet
Advantages of fanning
Spread product through a single entry point
Advantages of cross hatching
Fiill proad areas
Physical support & stability for tissues
Needle Pros
Easier to learn to use
Precise placement of prescise volumes
Easier to assess depth through tenting
Low dead space
Cheaper
Needle cons
Bruising
Higher risk of intravascular injection
More entry points required to spread product
Rigid and limited by length
Cannula Pros
Flexible
Blunt - Lower risk to critical structures
Single entry point, can spread product
Cannula Cons
More expensive
Increased risk of infection
Increased dead space
Less accuracy and control
At what gauge do cannulas become sharp
above 25G
Recommended areas for cannula
Deep mid face
Superficial temporal fascia
Nasolabial folds
Near angular artery
Safe injection rate
2 minutes/0.3ml
Needlestick injury management
- Encourage bleeding
- Wash wound with soap and water 2 minutes
- Fresh waterprood dressing
- Inform line manager
- Record incident
- Risk assessment for further blood test
