1. Injections Hana Svobodová

2. Types of containers Medications for injection are supplied in several types of container : Vials Ampules Cartridges

3. Utilising comfort measures ! Skill in administering injections minimizes pain ! Prior to injecting the medication : select the smallest gauge needle possible for the medication and injection site. inspect needle for sharpness tap the area lightly with fingertips rotate sites During injection : insert the needle quickly without hesitation inject the medication slowly (time for absorption)

4. After injection : withdraw the needle quickly massage the injection site to encourage absorption of the medication into the tissues – massage firmly but gently NOTE : contraindication is for intradermal injection, insulin, heparin

5. Intradermal injection = injection between layers of skin needle length – 0,6 – 1,3 cm syringe size – usually 1 ml (tuberkulin), common dosage is 0,01 – 0,1 ml needle insertion angle – 5-15 degree usualy i.c. (i.d.) are for DIAGNOSTIC purposes the substance injected into the skin causes a local reaction : Wheal Blanched or reddened area Itches (if the test reaction is positive)

6. The most common sites: aspect of the forearm or upper back Hold the syringe almost PARALLEL to the surface Do NOT massage the site after injecting the solution. Observe the reaction – the first 30 minutes after (for possibilitiy of serious allergic reaction or anaphylactic shock). Time for reaction varies from 15 min. to 24 hours. (MANTOUX – tuberculosis test)

7. SUB CUTANEOUS INJECTION Environment Preparation -Patient -Medication Administration

8. Injection Sites

9. Administering subcutaneous injections s.c. is placed just under the deep skin layer - the medication is absorbed more slowly the inj. i.m. or i.v. (during 20 – 30 minutes) needle length - 1,3 – 2,5 cm syringe size – usually less than 2 ml, common dosage is 0,5 – 2,0 ml needle insertion angle - 45 or 90 degree

10. Injection sites the upper arm (m. biceps brachii) the thigh (m. quadriceps femoralis,esp.for a self-administered inj.) the abdomen Dorsogluteal area For daily medication (diabetics) – the inj. site is rotated on a regular schedule. Way of application : - grasp the injection site between thumb and forefinger to form a pad of subcutaneous tissue

11. Complications Aplication to vessel aplication to musculus Hypertrofy of subcutaneous tissue lipodystrofy atrofy of skin Infection of the puncture place

12. administering s.c. injectionhttp://www.youtube.com/watch?v= hEtyrR0GhQghttp://www.youtube.com/watch?v= hEtyrR0GhQg