1. Clinical Medical Assisting
Chapter 11: Administering Injections and Immunizations

2. Objectives
Safely dispose of syringes, needles, and biohazard materials
State the relationship between the diameter and the gauge of the needle
Describe the site selection for administration of injections

3. Objectives (con’t)
Demonstrate intradermal, subcutaneous, intramuscular and z-track injections
Document administration of therapeutic injections ordered by the provider and administered by the medical assistant

4. Chapter Overview
Parenteral products are medications or other preparations intended for administration by injection, either through the skin or other external tissue, rather than through the gastrointestinal (GI) tract. Parenteral administration allows the active ingredient to be delivered directly to an organ, a lesion, a muscle, a nerve, or other body tissue. In addition to medication, fluids, electrolytes, and nutrients may be administered parenterally.

5. Types of Injections
Drugs can be administered into almost any part of the body.

6. Intravenous
Drugs can be administered into almost any part of the body, including a vein.

7. Intramuscular
IM injections are administered deep into a skeletal muscle.

8. Deltoid
The common locations are usually the deltoid (upper arm).

9. Dorsogluteal (back hip)
Another common injection location is the dorsogluteal (back hip).

10. Subcutaneous
The subQ route of administration is used for small volumes of medication.

11. Intradermal
ID injections are administered into the vascular layer of the skin between the dermis and the epidermis.

12. Equipment for Sterile Product Administration
To properly administer parenteral injections, personnel must have a working and usable knowledge of the equipment employed for such injections.

13. Syringes
Syringes are used for the preparation and administration of sterile pharmaceutical products.

14. Common Syringe Sizes
The most common sizes of hypodermic syringes for parenteral administration are 1mL, 3mL, and 5mL.

15. Needles
A needle is attached to a syringe and is the component that actually enters the medication vial, the container to hold medication for dispensing, or the body.

16. Needle Gauge
Refers to the diameter of the needle

17. Needle Lengths
Range from [3/8] inches to 2 inches

18. The Point
The sharp end of the needle

19. The Bevel
The bevel is the flat, slanted surface near the point

20. The Lumen
The hollow core of the needle that forms an oval-shaped opening at the beveled point

21. The Shaft
The hollow steel tube that runs the entire length of the needle

22. The Hub
The end of the needle that attaches to the syringe

23. The Hilt
The location where the hub attaches to the shaft

24. Hazards Associated with Parenteral Products
Administering injections requires caution—both for the patient and the healthcare worker.

25. The " 7 Rights of Drug Administration
Developed to help healthcare professionals ensure proper administration of any drug

26. Needlesticks
Accidental punctures of the skin caused by a needle or other sharp object

27. Needle Safety
Needlesticks and other sharps-related injuries are dangerous and expose healthcare workers to hazardous chemicals and infectious agents.

28. Occupational Safety
Needlesticks are an occupational hazard within the medical community.

29. Biohazard Materials
Biohazard materials are any infectious or dangerous bodily fluids, tissues, or other substances that pose a risk to the health or safety of humans or the environment.

30. Patient Safety
Caution must be practiced and appropriate technique must be learned to ensure safe administration.

31. Skills for the Medical Assistant
Medical assistants are often responsible for administering medications.

32. Reconstituting Sterile Powder for Injection
Some medications for parenteral administration are supplied as dry powder that requires reconstitution with a diluent prior to administration.

33. Reconstitution
The process of adding a liquid to a dry powder to make it suitable for injection

34. Equipment Needed
• Medication supplied as sterile powder for injection • Sterile water for injection • Disposable gloves • Syringe • Regular needle, 25-gauge, 1-inch length • Vented needle, 18-gauge, 1[1/2] inch length • Sharps container • Alcohol wipes

35. Withdrawing Medication from a Vial
Vials are available in single- and multiple-dose varieties.

36. Equipment Needed
• Medication order • 5mL syringe • Needle, 25-gauge, 1-inch length • Medication vial • Alcohol wipes • Disposable gloves • Sharps container

37. Using an Ampule
An ampule is a glass container with a single dose of medication or active ingredient, usually in a volume of no more than 2mL.

38. Equipment Needed
• Medication order • Ampule containing medication • 3mL syringe • Filter needle, 18-gauge, 1[1/2] inch • Regular needle, 25-gauge, 1-inch • Alcohol swabs • Trash container • Sharps container

39. Preparing to Administer Injections and Immunizations
Regardless of the route of administration, administering injections and immunizations requires attention to detail.

40. Equipment Needed
• Medication order • Medication vial or ampule • Appropriately sized syringe and needle • Alcohol wipes • Disposable gloves • Sharps container • Cotton ball • Adhesive strip

41. Administering Intradermal Injections
The most commonly administered ID injection is the purified protein derivative (PPD) injection to diagnose tuberculosis.

42. Equipment Needed
• Medication order • Medication vial or ampule • Needle, 27-gauge, [1/2] inch length • Alcohol wipes • Disposable gloves • Sharps container • Adhesive strip • Medicine tray

43. Administering Subcutaneous Injections
SubQ injections are most commonly used for administering certain narcotics, reproductive hormones, and insulin.

44. Equipment Needed
• Medication order • Medication vial or ampule • 1mL syringe • Needle, 25-gauge, [1/2] inch length • Alcohol wipes • Disposable Gloves • Sharps container • Adhesive strip • Medicine tray

45. Administering Intramuscular Injections
The muscle acts as a depot for slowly releasing drugs, leading to infrequent dosing of medications.

46. Equipment Needed
• Medication order • Medication vial or ampule • 3mL syringe • Needle, 25-gauge, 1 inch • Alcohol wipes • Disposable gloves • Sharps container • Adhesive strip • Medicine tray

47. Administering Intramuscular Injections with the Z-Track Method
The Z-track method of IM injections is used to minimize leakage into the subcutaneous tissue and outer layers of skin and allows no method of exit for the medication.

48. Equipment Needed
• Medication order • Medication vial or ampule • 3mL syringe • Needle, 25-gauge, 1 inch • Alcohol wipes • Disposable gloves • Sharps container • Adhesive strip • Medicine tray

49. Summary
Parenteral products are medications that are administered by injection rather than through the gastrointestinal tract. This allows an active ingredient to be directly delivered to an organ, lesion, muscle, nerve, or tissue. Parenteral administration is preferred when a patient is unable to take medication by mouth, when a patient is unconscious, or when a patient is vomiting.

50. Summary (con’t)
Needlesticks are an occupational hazard related to preparation and administration of injections and immunizations. Needlesticks also expose healthcare workers to blood-borne pathogens and other hazardous materials. Safety mechanisms and proper handling, storage, and disposal techniques minimize the risk of injury related to needles and other sharp objects.