Lecture 10

Question 1

What is the highest probability of needle breakage as far as anatomic location?

Answer 1

-IA using a short needle (30 gauge)

Question 2

How do you prevent needle breakage?

Answer 2

• Never use a short needle for IA
• Never use a 30 gauge needle for IA
• Never bend the needle at the hub
• Never use the soft tissues to bend the needle

Question 3

How do you avoid paresthesia from anesthetic?

Answer 3

• Strict adherence to injection protocol

- Avoid mechanical trauma to nerve

Question 4

How long does it take paresthesia to typically resolve?

Answer 4

-8 weeks

Question 5

How do you prevent facial nerve paralysis?

Answer 5

-A needle tip that comes in contact with bone

Question 6

What should a patient do experiencing facial paralysis?

Answer 6

• Remove contacts
• Eye patch to protect eye
• Reassure the pt, it will go away

Question 7

How do you prevent trismus?

Answer 7

• Sharp, sterile needle
• Properly handle cartridges
• Aseptic technique
• Atraumatic insertion and injection technique
• Avoid repeat injections
• Use minimum effective volumes of local anesthetic
• It is not always preventable

Question 8

What can cause trismus during an injection?

Answer 8

-Alcohol contamination

Question 9

How do you prevent soft tissue injury during an injection?

Answer 9

• Use LA of appropriate duration
• Warn the patient and advise against eating, drinking
• Use a warning sticker

Question 10

How do you manage soft tissue injury during an injection?

Answer 10

• Analgesics for pain
• Antibiotics as needed
• Lukewarm saline rinses
• Petroleum jelly or other lubricant

Question 11

What do you do to prevent a hematoma?

Answer 11

• Know your anatomy
• Modify injection technique
• Use a short needle for PSA
• Never use a needle as a probe
• Minimize the number of needle penetrations into tissue

Question 12

How do you prevent pain on injection?

Answer 12

• Adhere to proper techniques of injection
• Use sharp needles
• Use topical anesthetic properly before injection
• Use sterile local anesthetic solutions
• Inject slowly
• Temperature of the solution

Question 13

What is the main cause of the burning on injection?

Answer 13

-pH

Question 14

How do you prevent infection from injections?

Answer 14

• Use sterile disposable needles
• Properly care for and handle needles
• Avoid multiple injections with the same needle
• Use a cartridge only once
• Store cartridges aseptically in their original container

Question 15

What is the management of and allergy induced edema?

Answer 15

• .3 mg of epinephrine for adult
• . 15 mg for a child
• Histamine blocker
• Corticosteroid
• Cricothyroidotomy

Question 16

What can cause sloughing of tissues from an injection?

Answer 16

-Injecting Local Anesthetic to quickly

Question 17

Where is the most common place of sloughing tissues from an injection to occur?

Answer 17

-Palatal tissues

Question 18

What are 4 important things must be recorded every time you administer anesthetics?

Answer 18

• Type of local anesthetic
• Amount of local anesthetic
• Type of needle used
• Injection type administered

Question 19

Duty is a legal term meaning what?

Answer 19

-Patient and health professional interactions

Question 20

Breach of duty is a legal term meaning what?

Answer 20

-Fails to act

Question 21

Proximate cause is a legal term meaning what?

Answer 21

-Summation of actual cause and legal cause

Question 22

Damage is a legal term meaning what?

Answer 22

-element of the cause of action

Question 23

Consent is a legal term meaning what?

Answer 23

-Obtaining the patient’s permission prior to acting