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Local anesthesia setup

Also called: anesthetic setup, LA setup, injection setup

Topical, syringe, cartridge and needle, ready and passed out of the patient's sight.

Before most procedures the patient is numbed. The assistant sets out topical anesthetic, gauze, cotton-tipped applicators, the syringe loaded with the cartridge the dentist chose, the needle, and a recapping device. The syringe is passed below the patient's chin so they do not see it; for a right-handed operator the assistant holds it in the right hand. Every office's tray list is a little different; this is a common example. Follow your office's tray card.

How to spot it

  1. A loaded syringe with the cap on, next to a recapping device and a 2x2 gauze.

On the tray, in order

  1. 1. 2x2 gauze (to dry the site)
  2. 2. Topical anesthetic and cotton-tipped applicator
  3. 3. Aspirating syringe, loaded, harpoon engaged, needle capped
  4. 4. Extra cartridge(s) as the dentist directs
  5. 5. Needle recapping device
  6. 6. Air-water syringe tip and HVE for rinsing afterward

Safety and care

  1. Check the drug, strength and expiration date with the dentist before loading.
  2. Recap only one-handed or with a device, and agree with the operator ahead of time on how the needle cap comes off during the pass.
  3. Follow your state's rules on who may place topical or give injections.

Related

Sources: Dentalcare.com CE643. The Concepts of Four-handed Dentistry Including Ergonomic Instrument Transfer. Pages: zones of activity, single-handed transfer, two-handed transfer, scissors/hinged instruments, syringe transfer, non-locking forceps, New York City College of Technology (CUNY), DEN 2318. Lecture Session 10: Local Anesthesia Armamentarium, OSHA. Standard interpretation, 1994-04-29, recapping of contaminated needles (29 CFR 1910.1030), Malamed SF. Handbook of Local Anesthesia, 7th ed. Elsevier, 2020, OSHA. Bloodborne Pathogens Standard, 29 CFR 1910.1030