Injections

• Parenteral medication refers to any route other than the GI tract, referring to an administration of medication by injection with the use of a needle or syringe into a body tissue
• Parenteral mediation is preferred i patient is vomiting, unconscious or has a nonfunctioning GI tract. Medications act quickly because they are rapidly absorbed into the bloodstream
• Syringes are calibrated in hundreths, tenths or whole mL
• A: tip = end of syringe where needle is placed

  B: plunger= fits into the barrel to withdraw and inject meds

  C: barrel = outer calibrated portion to hold meds

  
• Luer Lok syringes require special needles that are twisted on the tip and locked in place VS Non-Luer Lok syringes require needles that slip onto the tip
• Insulin syringes are used for subcutaneous injection of insulin. They are calibrated in units rather than mL and have an orange cap.
• The gauge refers to the needle diameter. As gauge size decreases, needle diameter increases
• Packaging of parenteral medication differ between ampules and vials. Ampules are single use and vials can be single or multi dose
• Needles can be filtered or unfiltered
• Drawing meds from an ampule:

  • snapping open the ampule away from self
  • insert a sterile filter needle into the ampule
  • withdraw meds by pulling back on the syringe plunger
  • remove and discard filter needle and attach appropriate size sterile needle for administration
• types of vials are ready to use meds, meds to be dissolved (powder with a diluent) and meds to be diluted with a diluent to reduce concentration
• Drawing meds from a vial:

  • disinfect top of vial
  • roll between hands
  • pull back amount needed
  • insert needle in vial and push air in
  • withdraw needed amount of medication
• When reading labels, identify the unit of measurement and the type of syringe to be used
• subcutaneous tissue is found below the dermis and is used to allow slower absorption with the same plasma levels compared to the IM route which has a faster rate of absorption
• Important to remember for subcut injections:

  • aseptic technique with an alcohol swab for 30 sec
  • injection site is according to pt preference and thickness of subcut tissue
  • site rotation is important to avoid lipohypertrophy which created inadequate absorption (should maintain 2.5 cm from previous site)
• Contraindications for subcut injections are scarring, lesions, bony prominence, induration, bruising, infection, inflammation, necrosis
• Subcut injections are done et 45 or 90 degree angles
• Maximum volume to be injected into a site is 1ml for adults and 0.5ml for children. If the amount of medication is bigger, divide the amount into two injections
• Tips to minimize pt discomfort:

  • use a sharp needle
  • comfortable position
  • proper injection site following landmarks
  • divert the pt‘s attention
  • insert the needle quickly and smoothly
  • steady syringe and injection
• Step for needle-stick injuries:

  • wash thoroughly with soap and water
  • irrigate eyes with clean water or saline
  • report the incident to a supervisor
  • seek medical treatment less than 2 hours after
• Never recap a used needle, should use the scoop method. Should never put fingers in front of the needle to avoid injuries.
• 6 important rights to follow are right medication, dose, time, route, patient and reason