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IA Injections

Hi everyone,

I was wondering if someone could please tell me how to give a really good IA injection. Recently, I’ve had a hard time contacting bone and finding my landmarks, and it’s been causing me some frustration. Any tips or review would help so much! Thank you! 🙂



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2 Answers

One thing that really has helped me is placing my left thumb (I’m right-handed) in the patient’s coronoid notch then at the height of where the pterygomandibular raphe goes vertical, move the needle half way over to my thumb, then half way back (ending at 1/4 out from raphe) for the insertion point. Make sure the barrel of the syringe is over the contralateral premolars (for most patients).
 
Instead of regurgitating proper technique from Malamed’s local anesthesia book, if you still have yours, don’t hesitate to pull it out and review (even better if you have the CD that came with it, watch it). Most people are visual learners, so you could also check out YouTube videos of IA injections. There are some really good ones if you search YouTube. Another idea is if your doctor allows it, peek over his or her shoulder while they are giving injections to see landmarks firsthand. If your doctor doesn’t mind, it may be helpful for them to watch you give an IA (even if its to an a willing co-worker without depositing anesthetic) to help with your technique. Hands-on learning is the best! If there’s any local study groups, ADHA component meetings with injection technique CEs or conferences with injection technique CEs coming up in your area, I would suggest going to any or all of those.
 
Remember that patients don’t tend to have textbook anatomy and landmarks are different for each patient. Sometimes some patients are just more difficult to anesthetize than others. If you’ve been successful in the past with your technique, you may just be having a run of patients that are harder, so don’t get too frustrated! You got this!

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Thank you! This is very helpful!

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