Preparation by : Ali Sayma Health , Environment and Life Promotion Injection procedure Preparation by : Ali Sayma

Index: What the injection Type of injection How to prepare the injection How to give the injection (IV) (IM) (SC) (ID)

What is an injection? Injecting is the act of giving medication by use of syringe and needle to obtain the desired therapeutic effect taking into account the patients safety and comfort .

Why give drugs in injection? Injections usually allow rapid absorption Can produce blood levels comparable to those of intravenous bolus injections Injections can be given from 1ml and up to 2 mils in the Deltoid and up to 3 mls in the gluteal muscle in adults Drugs that are altered or not absorbed by other methods of administration

Routes of Medication Administration : Parenteral medication: administration of a medication by injection into body tissues. 1- Intradermal (ID) : into the dermis just under the epidermis . 2- Subcutaneous (SC) : into tissue below dermis of skin . 3- Intramuscular (IM) : into the body muscle . 4- Intravenous (IV) : into a vein .

Syringes : Three main parts: 1- Barrel – chamber that holds the medication. 2- Plunger – part within the barrel that moves back and forth to withdraw and instill medication. 3- Tip – part that the needle is attached to. Calibration: Syringe sizes from 1 ml to 50 ml Measure to a 1/10th or 1/100th depending on calibration

Needles : - Shaft of the needle Length chosen depends on the depth to which medication will be instilled Tip of shaft is beveled or slanted to pierce the skin more easily - Gauge: width of the needle (18 – 27 gauge) a smaller number indicates a larger diameter and larger lumen inside the needle

Considerations when choosing a syringe and needle : Type of medication Depth of tissue penetration required Volume of medication Viscosity of medication Size of the client

Equipment for the administration of injections : Tourniquet & gloves Needle of appropriate size Syringe of appropriate size Swabs saturated with isopropyl alcohol 70% 5 drug right

The 5 Rights of Drug Administration : Right client Right medication Right dose Right route Right time

Interdermal injection (ID) : Site: the inner aspect of the forearm. Needle size is 25 - 27 gauge, 1/2 to 5/8 inch. Insert needle at 15 degree angle. Injection made just below the outer layer of skin. If injection does not form a wheal or if bleeding is noted, the injection was probably too deep and should be repeated.

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Subcutaneous Injections (SC) : Medications absorbed in the fat Administered in areas of fat in the body Size gauge: Subcutaneous range = 25-27 How to admin? Pinch up the skin and inject at a 45 degree angle

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Intramuscular injection (IM) : How to admin? Hold skin taut and inject at a 90 degree angle whit Z-track method. Aspirate to be sure the needle in muscle. massage all IM injections except heparin.

IM INJECTION SITES : Deltoid Dorsogluteal Ventrogluteal Vastus lateralis Deltoid Find the lower edge of the acromial process and the point on the lateral arm in line with the axilla. Insert the needle 1 to 2 (2.5 to 5 cm) below the acromial process, usually two or three fingerbreadths, at a 90-degree angle or angled slightly toward the process. Typical injection: 0.5 ml (range: 0.5 to 2.0 ml). Dorsogluteal Inject above and outside a line drawn from the posterior superior iliac spine to the greater trochanter of the femur. Or, divide the buttock into quadrants and inject in the upper outer quadrant, about 2 to 3 (5 to 7.6 cm) below the iliac crest. Insert the needle at a 90-degree angle.Typical injection: 1 to 4 ml (range: 1 to 5 ml). Ventrogluteal Locate the greater trochanter of the femur with the heel of your hand.Then, spread your index and middle fingers from the anterior superior iliac spine to as far along the iliac crest as you can reach. Insert the needle between the two fingers at a 90-degree angle to the muscle. (Remove your fingers before inserting the needle.) Typical injection: 1 to 4 ml (range: 1 to 5 ml). Vastus lateralis Use the lateral muscle of the quadriceps group, from a handbreadth below the greater trochanter to a handbreadth above the knee. Insert the needle into the middle third of the muscle parallel to the surface on which the patient is lying.You may have to bunch the muscle before insertion.Typical injection: 1 to 4 ml (range: 1 to 5 ml; 1 to 3 ml for infants). 20

Z-track method:

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Intravenous injection (IV) : How to admin? 1- need to tourniquet 2- find vein & feel it by your finger 3- inject at 30 degree

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