The risk of an adverse reaction to a local anesthetic is increased when certain factors are present.

Risk Factor

Way to Reduce Risk

intravascular injection

aspirate for blood prior to injection

high blood flow or high vascularity in tissue, with rapid absorption

use of epinephrine to produce vasoconstriction

excessive dose

keeping dose within dose limits

excessive rate of administration

inject slowly

injection of wrong drug

label all syringes and vials properly, taking the time to read before injecting

failure to respond at the first sign of toxicity

monitor the patient closely and have emergency supplies readily available

history of allergy to local anesthetic or an adverse reaction

include in drug history


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