Multi-Site Injections

by Caitlin Denison, BS, RDH

Let’s say you’re getting ready to do a quadrant of scaling and root planning (SRP). You have a sensitive patient with deep pockets, so you’ve decided that local anesthetic is the best way to manage the patient’s pain and keep them comfortable during the procedure. You plan to administer the MSA and ASA blocks.

In situations like this, where we are giving injections at multiple sites, there are a few practices to keep in mind for patient and clinician safety, as well as regulatory compliance.

1. Always prepare your injection in a clean area free from contamination. Disinfect the rubber septum on the anesthetic carpule before puncturing it.
2. Never use a needle for more than one patient. While a single needle may be used to inject multiple sites on the same patient, this same needle may not be used on another patient. Remember, needles are single-use items and cannot be sterilized and reused.
3. Always sterilize your re-usable injection syringe between patients. Unlike needles, most dental aspirating syringes can be sterilized and reused.
4. Always recap the needle if it must be set down between injections to prevent injuries. Ensure that recapping is never done using two hands or any other technique that could direct the needle towards any part of the body. Use either a single-handed scoop technique for recapping, or a mechanical device designed to hold the needle cap.
5. Always place used needles in a puncture resistant sharps container that is labeled as biohazard. This container should be located as close as feasible to the area where the injection is given.
6. Never pass uncapped needles to another user.
7. Ensure that the Practice’s exposure control plan contains an explanation of why recapping is required as well as the procedure that is followed for safe recapping (single-hand technique or recapping device). OSHA may request this policy in the event of an inspection.