Module:

Session:

Advanced Care ParamedicineAdvanced Care Paramedicine

Medication Routes

6

4a

Routes

Parenteral administration of medications is typically done through: Subcutaneous Intramuscular Intravenous Endotracheal Intraosseous Inhalation

Subcutaneous

Subcutaneous

Prepare equipment Syringe Needle Alcohol swab 4 X 4 gauze Medication

Explain procedure Confirm allergies Examine medication, confirm that it is the desired

med, expiry date, cloudy/discolored? “Shake down” the ampule Break top off ampule using 4 X 4 gauze Draw medication into syringe and expel excess air

Subcutaneous

Choose suitable site Pinch up the skin Insert needle at a 45º angle Aspirate the syringe to

confirm placement If blood is aspirated,

withdraw needle and start over

Inject medication slowly Remove syringe and

dispose of Sharps Apply pressure over site Observe patient for effects Document

Intramuscular

Prepare equipment Syringe Needle Alcohol swab 4 X 4 gauze Medication

Explain procedure Confirm allergies Examine medication, confirm that it is the desired med, expiry

date, cloudy/discolored? “Shake down” the ampule Break top off ampule using 4 X 4 gauze Draw medication into syringe and expel excess air

Intramuscular

Choose suitable site Hold skin tight Insert needle at a 90º angle Aspirate the syringe to

confirm placement If blood is aspirated,

withdraw needle and start over

Inject medication slowly Remove syringe and

dispose of Sharps Apply pressure over site Observe patient for effects Document

Intravenous Bolus

Prepare equipment Syringe Needle Alcohol prep Medication

Explain procedure Confirm allergies Examine medication, confirm that it is the desired

med, expiry date, cloudy/discolored? Load medication Select appropriate IV port (closest to cannulation

site) Clean port with alcohol prep

Intravenous Bolus

Insert needle into port Pinch off IV tubing proximal

to port Administer medication as

required (Bolus, Slow IVP…)

Release IV tubing Remove needle Monitor patient for effect Document

Intravenous “Piggyback”

Prepare Equipment Medication IV solution Extra tubing Needle Label Medication

Explain procedure Confirm allergies

Intravenous “Piggyback”

Prepare medication in IV solution as required Label medication and [ ] of drug Attach needle to tubing and insert into patient’s IV

port Tape connection to IV line for security Begin administration

May need to place bag higher then the IV bag to allow gravity to work

Observe patient for desired effect Document

Endotracheal

Prepare equipment Hyperventilate the patient Remove BVM for ETT Inject medication directly into ETT Flush if Required Replace BVM and ventilate Monitor patient for desired effect

Intraosseous

Follow same procedures as IV administration