Download - Intramuscular and sucutaneous workshop
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
1) Drug2) Storage3) Route of Administration4) Dosage5) Preparation6) Timing7) Recording
7 POINTS TO CONSIDER BEFORE ADMINISTRATION!
Outpatient only!
The patient must have a complete prescription.
Check expiration date.
Ask for drug allergies.
1. Drug
Drug to be used have been stored properly.
Example: Vaccines (biologicals) should be stored in a
cold temperature (2 – 8 ᵒC)
2. Storage
Determine the best route of administration.
Factors:Age
Physical CharacteristicsClinical Condition
Dosage Form
3. Route of Administration
Calculate the dosage appropriately.
Double check with drug literature.
4. Dosage
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
Consider Drug-drug interaction and appropriate time interval between
administrations.
6. Timing
Observe proper documentation!
7. Recording
SUBCUTANEOUS INJECTION
SUBCUTANEOUS SITES OF INJECTION
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
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
INTRAMUSCULAR INJECTION
IM INJECTION SITES
Deltoid
Dorsogluteal
Ventrogluteal
Vastus lateralis
Note:Vastus lateralis and ventraogluteal sites used in infants
DELTOID MUSCLE
GLUTEUS MAXIMUS
GLUTEUS MEDIUS
VASTUS LATERALIS
Z-Track
• Minimizes tissue irritation by sealing the drug within the muscle tissues and decreasing pain.
• Recommended technique for all IM’s when possible.
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.
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
RETURN DEMONSTRATION
TIME!