1. Venipuncture
And Injections

2. Needle parts
Hub
Cannula (shaft)
Bevel
Point

3. Needle Selection
Length ¼ - 6”
Gauge 13 – 30g

4. Syringe Parts
Plunger
Barrel
Tip

5. Prepared Medications Ampule: Sterile prefilled container; single dose
Cartridge-Needle Unit: Disposable sterile cartridge w/ premeasured amount.
Vial: Sterile prefilled bottle

6. Flip top

7. Drawing Medications Ampule Vial Never remove ……… Never touch ………..
Ampule: hold alcohol swab over tip and break away from you
Vial: flip off rubber top, wipe with alcohol
Never remove metal ring unless pouring solution
Never touch hub of needle, needle or top of med container

8. Draw measured amount of air and exchange

9. INJECTIONS Site Selection
Intramuscular
Subcutaneous
Intradermal

10. Intramuscular
Used when meds given subcu are irritating; faster absorption; larger amount needed
90 degree insertion
Gluteus medius: Z-trak
Middeltoid
Ventrogluteal
Vastus Lateralis

11. Intramuscular Injections
Wipe surface in circular pattern from center to 2”
Let dry
Spread skin and insert needle 3/4
Do NOT insert needle to hub
Draw plunger to look for blood
Remove needle and massage muscle

12. Sites to Avoid Scar tissue Burned areas Edematous Traumatized
Areas near large vessels
Change in skin texture or pigment
Areas with a mole or wart

13. Gluteus Medius Draw line from greater trochanter to PSIS.
Injection given above and outside this line.
Watch out for sciatic nerve & gluteal artery.

14. Gluteus Medius

15. Z-Trak Upper outer quadrant of buttocks
Slide skin and gluteal muscle to side
Inject
Slide muscle back
Better absorption; less painful; less irritation; no discoloration due to leaking

16. Middletoid 3 fingers below edge of acromion and above axilla
Can only tolerate small amounts of meds
Major vessels, nerves and bones to be avoided here.

17. Middletoid

18. Ventrogluteal No major vessels or nerves here
Patient on side or supine
Palpate greater trochanter, iliac crest, ASIS.
Place your right palm on pts left troch, index finger on ASIS and middle finger along iliac crest.

19. Ventrogluteal

20. Vastus Lateralis Free of major blood vessels and nerves
Divide distance between greater troch and patella into thirds.
Use middle third.

21. Vastus Lateralis

22. Subcutaneous Small amounts (2> ml) Absorption through capillaries
Administer slowly
45 degree insertion
Heparin, epinephrine, insulin, vaccines

23. Subcutaneous Administered below epidermis Outer surface of upper arm
Lateral aspect of thigh
Upper 2/3 of back
Abdomen (2” around umbilicus)
Front of thigh
Rotate injections

24. Intradermal Skin tests for allergies Sensitivity to drug
TB test (susceptibility to disease)
To aid in diagnosis of parasitic infection and fungal diseases

25. Subcutaneous Tips Avoid edematous or scarred tissue
If patient is thin, grasp skin in a bunch
Do not aspirate
Do not rub area after injection

26. Intradermal Injection
Injected between layers of skin
Inner surface of forearm 4” distal to elbow
Insert bevel up at a 5-15 degree angle

27. NEEDLE SELECTION Subcutaneous 2-3cc Intramuscular 2-5cc or Intradermal
½-5/8”
23-25g
Intramuscular
2-5cc or
.5-2cc middletoid
1-1½”, 18-22g
1”, 22-23g
Intradermal
.5>cc
¼ ½ 3/8”
25-27g
Insulin
30,50,100units
½ - 5/8”
27-29”

28. VENIPUNCTURE Site Selection Needle Selection Short or long term use
Start looking distal
Needle Selection
Butterfly
Angiocath/Heplock

29. Venipuncture Insertion

30. Veins of Arm

31. Hand Veins

32. Recommended sites for venous cannulas

33. Sites To Avoid Tortuous Repeatedly used veins Poor skin condition
Thin, superficial veins
Bifucating veins
Veins affected by surgery

34. Infiltration Swelling or redness Cool skin at the site
Pressure or burning at site
No blood return