INJECTION DRAWING PROTOCOL
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Remove appropriate number of syringes and needles that will be used (outlined below).
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Always wear gloves. Wipe down the tops of injectables with an alcohol prep pad.
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Remove the lid of a syringe and place it in the sharps container.
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Insert the needle into the appropriate bottle and pull and press the plunger a few to
eliminate any air bubbles. If air bubbles DO form, tap the syringe until they rise to times
the top and press the plunger lightly to eject them.
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Draw the outlined amounts of injectables into the syringe. Carefully unscrew the 18
gauge needle from the syringe and dispose of in the sharps container.
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The syringe must now be set with the correct needle. In the case of numbing injections,
the syringe should be set with a 30 gauge needle. In cases requiring steroid injections, the
syringe should be set with a 27 gauge needle.
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The injections should always be wrapped in a paper towel before entering the room to
avoid distressing the patient .
All chloride, injections non-sterile should 3 be x set 3's, up and on 1 the alcohol counter
prep or pad.ins
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All patients waiting for injections should be given a pillow and any other comforts we
can offer.
Numbing Injections:
Ingrown Procedure Hallux (3 injections)
Both borders (4 injections)
Adult: ½ (1.5 ml) Lidocaine, plain + ½ (1.5 ml) Marcaine, plain. Child (under 15): 2 (3
ml) Lidocaine, plain (NO MARCAINE).
Digits 2-5 (2 Injections)
Same as above in most cases only 2 injections needed.
Total Nail Avulsion: (4 injections)
Adult: ½ (1.5 ml) Lidocaine, without epi + ½ (1.5 ml) Marcaine , without epi.
Child (under 15): 2 (3ml) Lidocaine, without epi(NO MARCAINE)
Total Nail Avulsion continued ..
Digit2-5 (2 INJECTIONS)
Same as above in most cases only 2 injections needed.
ENFT: (2 injections) one for each foot
½ (1.5 ml) Lidocaine, with epi + ½ (1.5 ml) Marcaine , with epi.
Biopsy/Excision: (standard 2 injections}
Number of injections depends on how large the area and the location.
½ (1.5 ml) Lidocaine, with epi + ½ (1.5 ml) Marcaine, with epi.
Child (under 15): 2 (3 ml) Lidocaine, with epi(NO MARCAINE).
Steroid Injections:
¼ (0.5 ml) Lidocaine with EPI + ¼ (0.5 ml) Marcaine with EPI + ¼ (0.5 ml)
Dexamethasone + TBA lines of Kenalog steroid. Number of Kenalog lines will vary on a
case by case basis. Dr. Stark will let you know how many lines of Kena log will be
needed.
Surgical Injections:
The number of injections will vary case by case. Ask Dr. Stark the day before surgery so
you can have the injections ready.
½ (1.5 ml) Lidocaine, with epi + ½ (1.5 ml) Marcaine, with epi.
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