3 medication administration
TRANSCRIPT
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
IV therapy and Medication Administration
Catherine Cabrera
Clinical Supervisor
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
10 Rights of Drug Administration
Right patient
Right drug
Right dose
Right time
Right route
Right to refuse
Right to assessment
Right to evaluation
Right to health education
Right documentation
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Knowing all drug administration protocols is essential.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
PPE
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Treat all blood and body fluids as potentially infectious.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Needle Handling Precautions
Dispose sharps in a sharps container.
“Fish Hook” when recapping.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Medication Administration and Documentation
Record all information concerning the patient and medication
Example:
0800H Cefuroxime 250mg via IV push given ANST.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
PERCUTANEOUS DRUG administration is drugs applied to and absorbed through
the skin or mucous membranes.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Transdermal
Absorbed through the skin at a slow, steady rate
Example:Topical OintmentSprayIntradermal
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Place the pill or direct spray between the underside of the tongue and the floor of the oral cavity.
Sublingual Medication Administration
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Place the medication between the patient’s cheek and gum.
Buccal Medication Administration
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Use a medication dropper to place the prescribed dosage on the conjunctival sac.
Eye Drop Administration
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Nasal Medication Administration
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Manually open the ear canal and administer the appropriate dose.
Aural Medication Administration
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Pulmonary Drug Administration
Medications are administered into the pulmonary system via inhalation or injection.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Metered dose inhaler
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Endotracheal Tube
Several medications can be administered through an endotracheal tube
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Enteral Drug Administration
The delivery of any medication that is absorbed through the gastrointestinal tract
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Gastrointestinal tract
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
1. Oral Drug Administration
Any medication taken by mouth and swallowed into the GI tract.
Be sure the patient has an adequate level of consciousness to prevent aspiration.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
2. Gastric Tube Administration
Gastric tubes provide access directly to the GI system.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Confirm proper tube placement.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Withdraw the plunger while observing for the presence of gastric fluid or contents.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Instill the medication into the gastric tube.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Gently inject the saline.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Clamp off the distal tube.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Rectal Administration
The rectum’s extreme vascularity promotes rapid drug absorption.
Medications do not travel through the liver, and are not subject to hepatic alteration.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Parenteral Drug Administration
Drug administration outside of the gastrointestinal tract.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Syringes and Needles
Syringe Hypodermic needle
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
AmpulesVials
Ampules and Vials
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Information on Drug Labels
Name of medication
Expiration date
Total dose and concentration
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Obtaining Medication from a Glass Ampule
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Hold the ampule upright and tap its top to dislodge any trapped solution.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Place gauze around the thin neck…
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
…and snap it off with your thumb.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Draw up the medication.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Obtaining Medicationfrom a Vial
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Confirm the vial label.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prepare the syringe and hypodermic needle.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Cleanse the vial’s rubber top.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Insert the hypodermic needle into the rubber top and inject the air
from the syringe into the vial.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Nonconstituted drugs come in separate vials. Confirm the labels.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Remove all solution from the vial containing the mixing solution.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Cleanse the top of the vial containing the powdered drug and inject the solution.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Agitate or shake the vialto ensure complete mixture.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prepare a new syringe and hypodermic needle.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Withdraw the appropriate volume of medication.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Parenteral Routes
Intradermal injection
Subcutaneous injection
Intramuscular injection
Intravenous access
Intraosseous infusion
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Intradermal Injection
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Assemble and preparethe needed equipment.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Check the medication.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Draw up the medication.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prepare the administration site.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Pull the patient’s skin taut.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Insert the needle, bevel up ata 10-degree to 15-degree angle.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Remove the needle and cover the puncture site with an adhesive bandage.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Monitor the patient.
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Subcutaneous Injection
45º
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Subcutaneous Injection Sites
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prepare the equipment.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Check the medication.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Draw up the medication.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prep the site.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Insert the needle at a 45-degree angle.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Remove the needle and cover the puncture site.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Monitor the patient.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Intramuscular Injection Sites
Deltoid
Dorsal gluteal
Vastus lateralis
Rectus femoris
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Intramuscular Injection
90º
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Intramuscular Injection Sites
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prepare the equipment.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Check the medication.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Draw up the medication.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Prepare the site.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Insert the needle at a 90-degree angle.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Remove the needle and cover the puncture site.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Monitor the patient.
© Scott Metcalfe
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Summary
10 Rights
Medication Administration Routes
Medication Package
Anatomy and Physiology related to Medication Administration
Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ
Questions?