PERS 5.2a1 infiltration injection 3.

45pm 30/11

1. Local Anaesthetic Procedure:

Guidance Notes:
Students should state the procedure to be carried out.
Students should explain how the clinincal area was made ready for this particular procedure, how
they assisted both the clinician and the patient during the procedure.
Students should describe the patient on which the treatment was carried out.
PROCEDURE TO BE CARRIED OUT: Endodontic Procedure- first stage of pulpectomy on
lower left 1 and the patient needed an infiltration injection to block the Lingual and Mental
nerves.
TYPE OF PRACTICE: Mixed NHS and Private dental practice.
AGE AND GENDER: Patient is 31 years male
MEDICAL HISTORY: fit and well, no allergies, no prescribed medications
SOCIAL HISTORY: Non-smoker; no alcohol
CONSENT: Written signature
MEDICAL RECORDS: Patient medical history was checked and made sure it was up to date.
Also, patient’s radiographs and dental chart were available on the computer for the dentist.
EQUIPMENT SWITCHED ON: Turned lights on, dental chair, compressor unit, computer, X-
ray machine, suction pump, light cure, amalgamator, water distillation unit, ventilation,
autoclave- which was filled with distillate water. A TST strip was placed in the autoclave for the
first morning cycle to check sterilisation process and recorded in the dated log book. The
ultrasonic bath was filled with enzymatic cleaning solution and water and de-gas process
started.
Patient was provided with safety glasses and protective bib.
PPE for the Dentist included- uniform, visor, disposable gloves, apron and mask.
PPE for the nurse (myself) – full uniform, including closed toe shoes, visor, apron, disposable
gloves and mask.
INSTRUMENTS: disposable tray liner, exam kit includes-mouth mirror, right-angle probe and
BPE probe, also tweezers, flat plastic, ball burnisher, plugger, spatula, fast and slow
handpieces with relevant burs, aspirating syringe, endodontic probe, endodontic block,
endodontic ruler, gates Glidden drills, barbed broaches, root canal hand files, endodontic apex
locator handpiece, reamers, rubber dam punch, rubber dam clamp forceps, rubber dam frame,
molar clamp, spoon excavator and scissors.
MATERIALS: Cotton rolls, topical anaesthetic gel, LA cartridge was 2% lidocaine
hydrochloride and adrenalin (epinephrine) 1:800000 with batch number-B228446AB and expiry
date- 06/2020, LA needle long-32 mm with 30-gauge thickness, paper pad for mixing,
disposable irrigating syringe whit needle, sodium hypochlorite, paper points, zinc-oxide based
endodontic dressing, periapical x- ray radiograph film, rubber dam, EDTA-endodontic
lubricant, temporary filling material, disposable aspiration tip, disposable 3 in1 tip and
disposable saliva ejector.
PREPARATION THE SURGERY: Prior to starting I confirmed the procedure with the dentist. I
prepared anaesthetic appropriate to the patient’s medical history which was checked with the
dentist. Afterwards I applied hand detergent to wet hands, washed and dried them with paper
towel. Put on new PPE- mask, visor and gloves. Disinfected all working surfaces: chair, control
buttons, bracket table, light handles, light, spittoon, computer, cupboards, x-ray machine,
amalgamator with viricidal disinfectant and paper towels. Then I flushed the lines through with
distilled water for 30 seconds to make sure the suctions were working, and the tubes were
clean. Afterwards I removed PPE-gloves, mask, visor and disposed in the clinical waste and
applied alcohol-based hand gel.
I discussed with the dentist prior to treatment if he needs any materials and then I put on new PPE- mask,
visor, gloves and set up for the clinical procedure.

For the appointment I added disposable aspirating tip, disposable saliva ejector and fitted
disposable 3 in 1 tip. I also applied disposable plastic covers for the armrest, light handle, head
cover, all couplets and over the aspirator tubes. Placed disposable cup with mildly antiseptic
mouthwash tablet and water provided on the side of the chair with a box of tissues for the patient.
Then placed the lined tray with instruments on the bracket table and connected handpieces. I
disposed of PPE- mask, gloves and visor in the clinical waste and washed hands.
In the clinical area I placed earlier a container with a lid, filled with enzymatic solution and water,
available to collect the contaminated instruments.
I greeted the patient in a friendly manner and sat him comfortably, and applied a protective bib and safety
glasses. I reassured the patient that there is nothing to be worried about the procedure.
For myself I placed PPE- mask, visor and gloves before the treatment started.
I was supporting the dentist with clear and dry operative field throughout treatment, using
retraction and aspiration techniques.
All along the treatment I was monitoring the patient whilst the local anaesthetic was being
admitted and also, for any signs of distress or discomfort to informed the dentist if necessary.
At the end of the procedure, I assisted the patient by removed the protective bib and safety
glasses and ensured he was cleaned before leaving the surgery.
The patient made an appointment for the second stage of the root canal treatment
I followed the practice guidelines, safety procedures and HTM-01-05 compliances.

2. Aim of the Procedure:

Guidance Notes:
Students should state the overall aim of the process.
The aim of an infiltration injection is to block local nerve supply to the tooth and for the dental procedure to be
carried out in order to produce the loss of pain sensation only. But pressure can be still felt by the patient.

3. Reflective Account:

Guidance Notes:
Students should identify their strengths and weaknesses during the procedure and describe any action they
would take to address weaknesses in the future, if required.
My strength for this procedure was to made sure the patient felt comfortable and reassure.
My weakness was that I didn’t offer the patient a water after the anaesthesia was given to rinse.

Preparation:
Student turned on all equipment required for the procedure:
Student donned appropriate PPE (gloves, mask, eye protection, appropriate clinical dress):
Student cleaned work surface using viricidal disinfectant or detergent solution:
Student flushed through all water lines:
Student applied disposable covers to required areas of the dental surgery e.g. light handles, control panel etc:
Student made all required patient records and radiographs available:
Student prepared all relevant equipment and materials:
Student established zoning of clean and dirty areas within the working field:

During Procedure:
Student greeted patient appropriately:
Student provided the patient with a bib and safety glasses:
Student aspirated and retracted soft tissues when appropriate:
Student followed safe practise procedures throughout:
Student monitored the patient throughout:
Student reassured the patient during the treatment:
Student ensured the patient was clean prior to leaving:

Professionalism:
Student demonstrated professionalism in his/her duties and effective team working towards the delivery of sa
Student demonstrated effective clinical decision making throughout the task:
Student managed themselves and the clinical environment in line with current standards and guidelines:
Student demonstrated knowledge and clinical skills appropriate to the patient's condition:
Student communicated appropriately, effectively and sensitively with the patient, their relatives or carers and