Injections 101

Objectives Describe proper techniques for administering injectable drugs Describe precautions to take when administering injectable products

7 Rights of medication administration 1. Right Drug 2. Right Dose 3. Right Time 4. Right Patient 5. Right Route 6. Right Technique 7. Right Documentation

Injection Sites see pages 459, 460

Routes of Administration

View Video clip DVD

Do Workbook page 527 E & H Hypodermic Syringe Calibrations 3cc syringe

Insulin Injection Sites Alternate sites include the back of the arms, thighs, and buttocks –Slower onset with alternate sites

Film Clip DVD

Workbook Questions 31-40, p 515

Preparing Syringe Maximum volumes – Deltoid – No more than 0.5-1mL – Large muscle (gluteus medius) Adult – no more than 4mL Child – no more than 1-2mL Vaccines: Vastus Lateralis in child Deltoid in Adult

Workbook Page 529 K Reading Syringe and Needle Labels

Preparing Needle Choose correct needle LENGTH and GAUGE Minimize tissue injury and SQ leakage Allow easy passage (21 vs. 25 gauge) Needle length depends on injection site – Adults 5/8 ” vs. 1 ” vs. 1.5 ” – Children 5/8 ” vs. 1 ” – If less SQ fat, use smaller needle

Do & Check Workbook page 528 I Insulin Syringe Calibrations U-100 syringe

Check your vials!!!!!

Drawing medication into Syringe (see page )

Get Organized Get all supplies ready ex: Band-Aid, alcohol pad, cotton ball Double Check – Correct med, dose, & expiration date – Go over med with pt

Record – Medication name, dose, route, time, date – Location of administration (L/R deltoid) – Your signature & title

Do & Check Workbook page 528 J Tb Syringe Calibrations 1-ml Tb syringe

Administer the injection Cleanse area with alcohol swab – Allow alcohol to dry Target/landmarks – C technique and shoot (IM) – Bunch skin (SQ) Aspirate (IM) then inject – smooth motion with steady pressure

Final Steps Do not recap needle Sharps container Apply pressure to injection site with cotton ball (PRN) Apply adhesive bandage PRN Chart Have pt remain for ~15 minutes

Workbook Key Terms Assessment page

Managing Adverse Reactions

Vasovagal Syncope (Fainting) Be aware of pt behavior Have pt sit before administration Lay pt down if necessary Check airway, breathing and vital signs

Anaphylaxis Rare but potentially fatal Occurs within 15 minutes Call 911 Lay pt down, check airway, breathing, vital signs Be prepared and ready to administer epinephrine (Epipen)

Delayed Adverse Reactions Child – fever, fussy, crying, injection site Adult – injection site discomfort Symptomatic relief – Fluids – Pain medications

Reporting Adverse Reactions Incident Report Required for: - Rare, serious or unexpected events

Workbook Page 530 section M Correct state the principle reason why we do that….. Incorrect explain why………

The Z-Track Method (page 461) Used with irritating meds meds that may discolor the skin you need to pull the skin to the side prior to inserting the needle Then inject the medication release the skin, the med will not be able to seep back to the skin’s surface DVD

Z-track Injection

Intradermal (ID) Injection Small amount of liquid is injected within the top layer of skin a small “wheal” or bubble appears on the skin Do not rub

Intradermal (ID) Injection cont. Common sites –upper chest –upper back –anterior forearm – DVD

Intradermal Skin Test

Tuberculin Skin Test Administered intradermally Exposure to Tb A small amount of TB protein (antigens) is injected the skin will react by developing a firm red bump at the site within 2 days ~ Positive skin test cannot tell if the infection is active or inactive (latent)

Positive TB skin test

Performing a Tuberculin Skin Test A circle may be drawn around the test area with a pen Do not cover redness at the skin site is expected and the site may itch, DO NOT scratch pt MUST return to the office within 2 to 3 days after the test for reading

Tuberculin Skin Test Results Redness alone is a negative reaction A firm bump is a positive reaction The size of the firm bump (not the red area) should be measured 2 to 3 days after the test MA reports the findings of “positive” or “negative” interpreting” such test results is MD job

Measuring Mantoux Test Reactions Workbook Page 531 Section N Measure and Chart Charting example see page Textbook

What is Intravenous Therapy? involves administering fluids and solutions directly into the bloodstream Not legal for CA MA’s