#4 – Load anesthetic syringe

A local anesthetic works by diffusing through the nerve membrane and interfering with the sodium and potassium transport mechanism. Extra syringes are in the C&S area. The regular syringes use Septocaine anesthetic capsule. If the appointment is for longer than 1/2 hour on an upper tooth use a gray (Septocaine) anesthetic, if 1/2 hour or shorter, use a white (isocaine) anesthetic. Anesthetic lasts much longer on lower teeth than on upper.

Inspect the anesthetic carpule before inserting it into the syringe for: 1. Large bubbles (more than 1 mm in diameter) these are caused by freezing 2. Extruded rubber plungers this means the carpule has been contaminated 3. Cracks and chips of the cartridge mean contamination 4. Check the expiration date.  Brown discoloration means the preservative has expired

Pull back on the ring and insert the carpule. Remove the yellow needle clear plastic hub cover and screw it on to the syringe. Don’t remove the yellow needle cover! Smack the ring sharply to make sure the harpoon tip is lodged firmly in the rub stopper. Lay the syringe on the tray out of sight of the client as much as possible.

The PeriPress is the new way to deliver anesthetic. The carpule (always) fits into the metal barrel that is screwed onto the gun. The needle then screws onto the barrel.

The Wand can be used for teeth on the lower jaw. Place the Wand machine into the room on the doctors cart and plug it in, the Wand will reset itself to the loading position. The Wand’s syringe, needle, and are located ____________. Open the package that contains the syringe and the needle, insert one carpule of Septocaine and push it so the carpule is pierced. Place the end with the Septocaine in the back hole of the Wand and line up the tabs, push it all the way down and turn it 90 degrees until it locks into place. Unwind the hose and place the needle end into its holder, the front hole.

Length of action 1. 1: 100,000 Neo cob (red writing) infiltration 1/2 2 min. – onset, 60 minutes duration, wears off in 2 1/2 hours. Black 1 5 min. onset, 1 1/2 2 1/2 hrs. duration, 3 5 hrs to wear off. 2. Plain (white writing) Lasts 20 min. in upper jaw and 40 min. in lower jaw.

General precautions by dentists 1. Proper dosage 2. Aspirate to avoid injecting into artery, vein 3. Be ready for emergencies 4. Epinephrine red carpule watch on patients with heart/thyroid problems

Watch for client symptoms after injection:  Restless Anxious Talkative Sweating Nausea Dizziness Blurred vision Sleepy

Allergic reactions: Itching Swelling Redness No breathing Heart stop beating

Treatment for reactions 1. Lay back 2. Oxygen maintain airway 3. CPR if needed (call 911) 4. Ammonia inhalant if needed

Client conditions to watch out for 1. Allergies to local anesthetics 2. Kidney disease 3. Pregnancy 4. Heart disease 5. Diabetes

Maximum dosage

1. 40 lbs. 2 carpules

2. 60 lbs. 3 carpules

3. 80 lbs. 4.5 carpules

4. 100 lbs.+ 5 carpules (maximum)

Precautions 1. Never autoclave a carpule 2. Don’t leave carpules exposed to light for more than 1/2 day 3. Disinfectant with Dentaphene 4. Don’t store in alcohol 5. If a rubber stopper sticks out of back of glass tube, throw the carpule away 6. Store unused carpules at room temperature 7. Throw away any partially used cartridges when an appointment is completed