Was I wrong? Needle question

Published

I work for a dentist (The Dr. and I are married) that is licensed for and does IV sedations. With IV cases, the patient is given a small bleb of local at the anticipated IV site to ease discomfort of insertion.

My question...Is it okay to use the same needle in the mouth that was used to give the anesthetic bleb for the IV? (We use the same kind of anes. and actually, the same gauge needle, for both tasks)

I do not feel like it is. The Dr. commented that the mouth is super dirty (true) and that it shouldn't make a difference. I would have brought it up with the Dr. later in private, but he was upset with an assistant that was about to change the needle after the IV anes. was placed and I was concerned that he was going to use the same needle in the mouth.

I really felt like I was advocating for the safety of my patient. But I also know that I 'corrected' the Dr. in front of other staff and really put him on the spot. What do I do??? Does anyone have any articles or documentation on something like this?

Up Vote Up Vote ×
Specializes in Nephrology, Cardiology, ER, ICU.

Once a needle is used, its used, it must be tossed, not reused....

Heres a fact sheet from the CDC:

http://www.cdc.gov/ncidod/dhqp/PS_SyringeReuseFS.html

And yet another on not maintaining asepsis from the CDC:

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm

Maybe I'm misunderstanding here: you are saying that the dentist injects into the IV line FIRST than the mouth? Or the other way around? Either way, if I was the pt, I would be reporting this to the state.

Up Vote Up Vote ×
Specializes in Critical Care, Insurance Case Management.

New stick = new needle!

Up Vote Up Vote ×

You shouldn't feel nervous.

This is something he should know. If he fusses, just tell him you'd hate to have him dealing with a nice little, say...abcess... that gets into the sinus/bone... and that pesky thing called the brain. Dentists sometimes like to hark back at how they used to never use gloves etc., etc., thing is they do have education in all of this, but since they don't deal with the medicine side of things, but for just the periphery, they can get this "that never happens" way of practice. It probably won't but then again that patient can end up in the ER, with everybody wondering how he got so sick.:twocents:

Up Vote Up Vote ×
Specializes in Maternal - Child Health.

I agree with 2ndwind.

The normal bacterial flora of the skin is likely to be very different than the normal bacterial flora of the mouth. I would imagine that the bacteria from the skin that contaminates the needle could cause a serious infection when introduced into the deep tissues of the mouth.

His practice is unsound and unsafe. If he argues, perhaps he would agree to have the Department of Health Infectious Disease Specialist settle the argument.

Up Vote Up Vote ×

I agree with the alternate flora concept. That was actually my first thought and the main basis for my speaking up. Yes, it's the same patient. But a totally different part of the body and a new stick!

I just have this really bad situation with us being married and all...:banghead:

He is very well versed with the sedation protocol and safety, etc., but IV's are a bit newer to him (used to do just oral sedation). I'm hoping we can talk about this civilly in the next few days while the office is closed for holiday.

Up Vote Up Vote ×
Specializes in retail NP.

As an infusion nurse, i can tell you this is a really bad idea. The needle isn't even sharp after using it once, therefor doing more damage to the lumen of the vein. All IV needles are designed for one "poke" and designed to pierce the epidermis/dermis. not the fragile oral mucosa. Osteomyelitis, bacteremia and sepsis can result from what you have described. Not to mention lawsuits and the risk of losing ability to practice (for all involved). it's worth the extra money in the short-run to avoid millions of dollars and infections in the long run. Ask him to take this all into advisement, stat!

Up Vote Up Vote ×

Maybe I didn't clarify myself on one point--he is NOT using an IV needle in the mouth! I am referring to the syringe needle (28 or 30 gauge) for the local anesthetic.

But a needle nonethless...

Up Vote Up Vote ×
Specializes in Med/Surg.

It's wrong, very wrong. Draw up one syringe with a small amount of lidocaine for the IV start and a seprate syringe with the amount of lidocaine anticipated to be used to deaden the area to be worked on.

It's not only wrong, it's dangerous, lazy and cheap. Husband or no, make him stop, it will be cheaper than paying legal fees.

Up Vote Up Vote ×
Specializes in jack of all trades.
Maybe I didn't clarify myself on one point--he is NOT using an IV needle in the mouth! I am referring to the syringe needle (28 or 30 gauge) for the local anesthetic.

But a needle nonethless...

Doesnt matter, I wouldnt use the same needle to for lidocaine to prep for needle cannulation in dialysis then use it on the same pt for the second needle prep. One stick then toss and get a new one. If I was his pt I would be running the other direction!!! I agree with previous posters in regards to setting up a pt for abscess, mrsa, etc this way. EEEKK is all I can say, by the way I was responsible for infection control standards in my unit and this would horrify me.

Up Vote Up Vote ×
Specializes in ICU.

I agree. On a related note, IIRC, our policy on regitine use after dopamine infiltration calls for a new needle for each individual SQ injection - and those injections are all going into the same site!

Good luck convincing the hubby. ;)

:paw:

Up Vote Up Vote ×

Needles should never ever be reused. i dont care where it was.

just dont do it.

mouth is very very dirty place meaning that needle is very very contaminated.

Up Vote Up Vote ×
+ Join the Discussion