Let me start this stating that I am a new grad. I have been a circ for about a month and a half.
It was brought to my attention that one of our surgeons has been injecting 1% lido w epi into the neck for his ACDFs without aspirating the syringe. The person who commented was the CRNA.
We draw up a max of 10cc per syringe for him. Each stick he gives a max of 2cc. He palpates the neck once before starting the injection. He doesn't palpate between sticks. I agree with the CRNA that he is too close to the carotid to not be aspirating. But of course the plot thickens...
This surgeon is our humble little hospital's money maker. He is also the grumpy sort that gets "uppity" nurses canned. So if I call him out, I've got to be completely sure that I'm right. He wouldn't be happy about getting corrected by a new nurse. Personally I don't give a hoot how he feels about me if I'm doing the right thing for my patient.
So should he be aspirating when giving these locals? Is this a grey area? I honestly don't know what 1-2cc of 1% would do to a healthy heart. Would that amount cause rhythm issues in a normal adult? Is this a battle I need to fight?