Was I wrong? Needle question

[mel j rn]

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?

[TiffyRN, BSN, PhD]

I thought I've seen multiple dentists using the same needle for multiple injections in my mouth. I'm just saying maybe dental standards are different. I can conceive that a dentist would be comfortable taking a sterile needle, sticking it under the skin, then taking this unclean needle and injecting a super dirty area that is the mouth. They do not use a sterile needle for each poke into your gum and they are pulling out from a filthy area and re-injecting over and over and over (I've had way too much dental work).

Having said that I have a nasty ulcers every time I've ever had local in my mouth and there's no doubt why. But maybe the standards for injections into the mouth are different. If you are going to inject my gums multiple times with the same needle, it's going to be much much cleaner if it just came out of my intradermal space than from anywhere in my mouth. If I were an RN working in a dental office I would need to become familiar with the standards for injections for local dental anesthesia. Having said that, though I believe the practice described in the OP is not harmful, I doubt any dental organization would approve and would probably insist on separate needles for each part of the body.

Dental anesthesia injections are in no way sterile. I believe the only reason they sterilize them is to prevent transmission of disease from the previous patient.

By the way, all my knowledge of dental anesthesia comes from personal experience having it. All but 2 of my non-incisor teeth have crowns and at least half of those were root canals.

[nursel56]

Don't know why he'd object to using a new sterile needle in the mouth? Needles are too expensive? He'd have to take a few extra minutes to do that?

Related subject, most Docs I see use the same needle to inject lidocaine around the site of a laceration for example, before suturing it. Is that just as bad as multiple injections in the mouth or using the same needle for the skin as you do for the mouth? Interesting subject.

[litbitblack, ASN, RN]

Yes i would say he would need to change the needle as it is going to a totally different area of the body. If it was a needleless system and he wanted to use the same syringe i would think that was ok but its going into iv tubing then into the mouth so its a different site.

[blondy2061h, MSN, RN]

No, there is no way I would reuse that needle. It's a risk for needle sticks for the staff. It's a risk for infection for the patient. The needle's integrity is compromised after one stick and you risk the needle hurting more the second time or even breaking off inside the patient. Eck! What would even give the dentist the idea that this is okay is beyond me. Why you're routinely numbing (presumably) adults for an IV stick is also beyond me.

[WalkieTalkie, RN]

Yuck!