Dental broken needle migration to the skull base: a case of dental broken needle migration to the skull base: anatomical considerations and prevention

Introduction: the needle fracture during the inferior alveolar nerve block is not a common accident, but whenit occurs can cause great inconvenience to the professional and patient, because the surgical removal shouldonly be performed without risk of sequelae to the patient. Aim: relate a case of broken dental needle duringinferior alveolar nerve block and the needle fragment dislocation to the skull base becoming impossible itssurgical removal. Described preventive procedures to avoid that complication with anatomical considerationsrelated to the inferior alveolar nerve block. Case report: a young female, 18 years old required care afterfracture of the dental needle during inferior alveolar nerve anesthesia. She was submitted to CT scan thatdetermined the impossibility of surgical removal of the fragment because it has migrated to the skull basebecoming close to vital anatomic structures because its could produce irreparable sequelae such loss of tonguesensation and movement of the lip. A conservative treatment was offered. Conclusions: surgical removal ofits instrument should be correctly evaluated to avoided irreparable sequelae to the patient. The knowledgeof anatomical structures in the pterigomandibular region may reduce the risk of injury to nerves and anotherstructures and prevent further complications.

Acidente com material biológico em hospital universitário do oeste do Paraná / Accidents with biological material in a university hospital from west Paraná

Estudo descritivo, retrospectivo realizado com o objetivo de investigar os acidentes de trabalho com material biológico, que envolveram trabalhadores e estagiários, ocorridos em 2003 e 2004 num hospital universitário do Paraná. Na coleta dos dados foi utilizado o formulário eletrônico da Rede de Prevenção de Acidente de Trabalho-REPAT. Dentre os 586 trabalhadores do quadro funcional do hospital, houve registro de 20 (3,4%) trabalhadores acidentados em 2003 e 23 (3,8%) em 2004, o que representou acréscimo de 15% nas notificações de um ano para o outro

Needle stick injuries among medical students.

Questionnaires were distributed among 200 medical students regarding safety precautions observed while perfonning various invasive procedures during their clinical posting. Only 106 students responded with the completed questionnaire. The most common procedure performed by the students was drawing of blood, with an average frequency of 60.8 per month. Sixty-one per cent of the students reported being injured during the various procedures and only 3 5.5% of them used gloves. Resheathing the needle was responsible for causing injury to 69% of the students, which was significantly higher than injuries occurring while entry into the vein or withdrawing the needle (p<0.05).