VenipunctureVenipunctureVenipunctureVenipuncture
And InjectionsAnd Injections
Needle parts• Hub• Cannula (shaft)• Bevel• Point
Needle Selection• Length ¼ - 6”
• Gauge 13 – 30g
Syringe Parts• Plunger• Barrel• Tip
Prepared Medications• Ampule: Sterile prefilled
container; single dose• Cartridge-Needle Unit: Disposable
sterile cartridge w/ premeasured amount.
• Vial: Sterile prefilled bottle
Flip top
Drawing Medications• Ampule• Vial• Never remove ………• Never touch ………..
Draw measured amount of air and
exchange
INJECTIONSSite Selection
• Intramuscular
• Subcutaneous
• Intradermal
Intramuscular• Used when meds given subcu are
irritating; faster absorption; larger amount needed
• 90 degree insertion• Gluteus medius: Z-trak• Middeltoid• Ventrogluteal• Vastus Lateralis
Intramuscular Injections
• Wipe surface in circular pattern from center to 2”
• Let dry• Spread skin and insert needle 3/4• Do NOT insert needle to hub• Draw plunger to look for blood• Remove needle and massage muscle
Sites to Avoid• Scar tissue• Burned areas• Edematous• Traumatized• Areas near large vessels• Change in skin texture or pigment• Areas with a mole or wart
Gluteus Medius• Draw line from greater trochanter
to PSIS.• Injection given above and outside
this line.• Watch out for sciatic nerve &
gluteal artery.
Gluteus Medius
Z-Trak• Upper outer quadrant of buttocks• Slide skin and gluteal muscle to side• Inject• Slide muscle back• Better absorption; less painful; less
irritation; no discoloration due to leaking
Middletoid• 3 fingers below edge of acromion
and above axilla• Can only tolerate small amounts of
meds• Major vessels, nerves and bones to
be avoided here.
Middletoid
Ventrogluteal• No major vessels or nerves here• Patient on side or supine• Palpate greater trochanter, iliac
crest, ASIS.• Place your right palm on pts left
troch, index finger on ASIS and middle finger along iliac crest.
Ventrogluteal
Vastus Lateralis• Free of major blood vessels and
nerves• Divide distance between greater
troch and patella into thirds.• Use middle third.
Vastus Lateralis
Subcutaneous• Small amounts (2> ml)• Absorption through capillaries• Administer slowly• 45 degree insertion• Heparin, epinephrine, insulin,
vaccines
Subcutaneous• Administered below epidermis• Outer surface of upper arm• Lateral aspect of thigh• Upper 2/3 of back• Abdomen (2” around umbilicus)• Front of thigh• Rotate injections
Intradermal• Skin tests for allergies• Sensitivity to drug• TB test (susceptibility to disease)• To aid in diagnosis of parasitic
infection and fungal diseases
Subcutaneous Tips• Avoid edematous or scarred tissue• If patient is thin, grasp skin in a
bunch• Do not aspirate• Do not rub area after injection
Intradermal Injection• Injected between layers of skin• Inner surface of forearm 4” distal
to elbow• Insert bevel up at a 5-15 degree
angle
NEEDLE SELECTIONSubcutaneous
2-3cc ½-5/8”23-25g
Intramuscular
2-5cc or.5-2cc middletoid
1-1½”, 18-22g1”, 22-23g
Intradermal .5>cc ¼ ½ 3/8”
25-27g
Insulin 30,50,100units
½ - 5/8”
27-29”
VENIPUNCTURE• Site Selection
– Short or long term use– Start looking distal
• Needle Selection– Butterfly– Angiocath/Heplock
Venipuncture Insertion
Veins of Arm
Hand Veins
Recommended sites for venous cannulas
Sites To Avoid• Tortuous• Repeatedly used veins• Poor skin condition• Thin, superficial veins• Bifucating veins• Veins affected by surgery
Infiltration• Swelling or redness• Cool skin at the site• Pressure or burning at site• No blood return