intramuscular and sucutaneous workshop
TRANSCRIPT
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INTRAMUSCULAR & SUBCUTANEOUS INJECTIONWORKSHOP
LORELEI J. CABALUNA, RN, MNBotany Lecture and Laboratory Room
August 22, 201412:00 nn to 4:00 pm
Adventist Medical Center CollegeDepartment of Pharmacy
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1) Drug2) Storage3) Route of Administration4) Dosage5) Preparation6) Timing7) Recording
7 POINTS TO CONSIDER BEFORE ADMINISTRATION!
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Outpatient only!
The patient must have a complete prescription.
Check expiration date.
Ask for drug allergies.
1. Drug
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Drug to be used have been stored properly.
Example: Vaccines (biologicals) should be stored in a
cold temperature (2 – 8 ᵒC)
2. Storage
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Determine the best route of administration.
Factors:Age
Physical CharacteristicsClinical Condition
Dosage Form
3. Route of Administration
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Calculate the dosage appropriately.
Double check with drug literature.
4. Dosage
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Observe STERILE TECHNIQUE!
Remove remaining air inside the syringe prior to administration.
Syringe and needle must be appropriate for the amount of solution.
5. Preparation
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Consider Drug-drug interaction and appropriate time interval between
administrations.
6. Timing
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Observe proper documentation!
7. Recording
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SUBCUTANEOUS INJECTION
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SUBCUTANEOUS SITES OF INJECTION
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IMPLEMENTATION• Wash hands, provide privacy• Select an injection site (no bruises, edema,
inflammation, scars), if abdomen at least 2 inches away from umbilicus, rotate injection sites
• Apply gloves, hold a dry gauze in nondominant hand
• Cleanse site with antiseptic swab (allow to dry)• Remove needle cap• Hold syringe between thumb and forefinger of
dominant hand
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IMPLEMENTATION
• Pinch skin with nondominant hand• Inject firmly at appropriate angle• With needle in site, grasp lower end of syringe
with nondominant hand and inject medication with dominant hand on plunger
• Remove needle and place dry gauze over site with gently pressure (do not massage)
• Discard needle and syringe• Remove gloves and wash hands
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INTRAMUSCULAR INJECTION
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IM INJECTION SITES
Deltoid
Dorsogluteal
Ventrogluteal
Vastus lateralis
Note:Vastus lateralis and ventraogluteal sites used in infants
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DELTOID MUSCLE
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GLUTEUS MAXIMUS
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GLUTEUS MEDIUS
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VASTUS LATERALIS
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Z-Track
• Minimizes tissue irritation by sealing the drug within the muscle tissues and decreasing pain.
• Recommended technique for all IM’s when possible.
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IMPLEMENTATION• Privacy• Wash hands• Expose only required area• Select appropriate injection site & ensure client is
comfortable• Landmark site• Cleanse site with antiseptic (center and rotate outward ~
5 cm)• With nondominant hand, pull skin 2.5-3.5 cm down or
lateral (Z track), hold this position until medication is administered.
• Gauze in nondominant hand.
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IMPLEMENTATION• Remove cap (pull straight off)• Hold syringe like a dart• Inject quickly at 90 degrees• Hold lower part of syringe to stabilize syringe• Pull back on plunger 5-10 sec, if no blood inject
medication slowly (1 ml/10 sec)• Wait 10 sec, slowly withdraw needle, place gauze
over site• Assess site• Observe response to medication
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RETURN DEMONSTRATION
TIME!