Injecting a certain structure doesn’t make any sense if there’s no correct and specific diagnosis. Therefore, clinical reasoning is at all times imperative. Before an injection or an infiltration is given, the following questions must be answered…
Take into account following considerations :
In an epidural local anaesthetic injection procaine is used ; if the result is insufficient, triamcinolone acetonide can be added.
Nerve compression phenomena (median or ulnar nerve, compression of the nerve roots L2-L5, S1 by an irreducible disc protrusion) can be treated by an infiltration of triamcinolone acetonide about the nerves.
It goes without saying that an injection or an infiltration can only be given after careful disinfection of the skin. The site of puncture and its surroundings are best disinfected with a 10 % polyvidon iodine solution, making a circular movement from the centre towards the periphery. Time of contact : 35-45 seconds.
In case of iodine allergy, a 70 % isopropanol solution is used. Time of contact : at least 12 seconds.
After the local disinfection, the site of puncture is not touched any more. Therefore it is essential, before the disinfection, to mark with a dermographic pencil the site of puncture and the possible anatomical points of reference in the vicinity.
After the disinfection the needle, syringe and fluid are collected in the most sterile manner.
After the injection or infiltration the site of puncture is disinfected with a 70 % isopropanol solution and covered with a sterile plaster.