subcutaneous intramuscular injections administer and monitor medication in the work environment...
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Subcutaneous Intramuscular Injections
Administer and Monitor Medication in the Work Environment
Topic 8 Subcutaneous
Administering injections
• Subcutaneous – into the fatty sc layer of tissue under the dermis
- not as richly supplied with blood vessels as muscle ... slower absorption
- Normally takes at least 30 mins for absorption – can provide the sustained effect needed with certain drugs
Administering injections
• Subcutaneous - sites include: abdomen, arms (posterior surface), thighs (anterior surface), and hips
- only small doses 0.5 – 1ml can be given – pain receptors sensitive to irritating solutions
- Body weight of the individual indicates the depth of sc layer
SUBCUTANEOUS INJECTIONS
SPEED OF ABSORPTION
Administering injections• Subcutaneous
What equipment do you need?
Equipment – SC Injection
What needle should I use for SCI injections?
25G or 27G
Orange or grey hub
Procedure
• Subcutaneous
- Perform the standard protocol for beginning the procedure
- Attach the drawing up needle to the syringe
If using a vial – swab top of vial with an alcohol wipe
If using an ampoule – gently tap to dislodge and med. above the neck
Procedure• Subcutaneous- snap open the ampoule – may use a
gauze square to protect your fingers from broken glass; may need to use a file to help snap the ampoule
- Draw up the correct amount of medication- Remove the needle from the syringe &
dispose into sharps container
Procedure
• Subcutaneous
- attach the administration needle to the syringe & expel air & any surplus medication
- Transport all equipment to the client using a kidney dish or suitable tray
- Access the injection site & when appropriate, clean it with alcohol
Procedure
• Subcutaneous- Allow site to dry for about 10 secFor insulin injections, the site is not
swabbed with alcohol if it is clean- pinch a fold of skin upwards, insert 2/3 of
the needle at a 45 – 900 angle holding the syringe like a dart
- Inject the medication slowly & smoothly
Procedure
• Subcutaneous- withdraw the needle smoothly- Place an alcohol swab or gauze over the
site for a few seconds but do not massage as this may speed up the absorption or may cause bleeding into the tissues especially if administering heparin
- Complete the standard protocol for ending the procedure
Things to consider…
• Anything that interferes with the local blood flow to tissues affects the rate of drug absorption e.g. exercise, hot/cold compresses to the area ... do not give sc injection
• Do not inject into an infected area, scar, near a bony prominence or into underlying muscle or nerves
Things to consider…
• Avoid using any site within 5cm of the umbilicus – proximity to large blood vessels
• Educate clients who need regular sc injections to rotate sites within the one area (for diabetics, this ↓s variability of insulin absorption) – injections should be given at least 2.5cm away from previous site & each site should not be used again for 1 month
Things to consider…
• Insulin pens – small prefilled cartridges loaded into a device that looks like a pen – some are disposable, others reloadable.
- a very fine needle is on the tip of the pen – many are coated with silicone = less painful injections
- Users turn a dial to select the required dose & then press the plunger on the end to inject the insulin
Things to consider…
• Continuous sc medications- often used as an alternative to repeated
IV, IM or SC boluses- Mainly used for analgesia & insulin- Less expensive, less risks & can be used
in client’s home- Associated with better pain control & less
sleep disturbance when compared with IV admin.