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HBCS2 > Drug Administration > Flashcards

Drug Administration Flashcards

1
Q

What should be done before administering any drugs?

A

Informed consent should be given from the patient, an advocate or guardian

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2
Q

Key areas of risk when administering drugs

A

right patient
right drug
right route
right time
right dose
right documentation

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3
Q

How many presentations of paracetamol do ambulances carry?

A

3

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4
Q

When documenting administration of drugs what elements are essential?

A

batch number
time given
presentation of drug
how much was administered
expiry date

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5
Q

Parental Routes

A

Intramuscular
Intravenous
Subcutaneous

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6
Q

Non-Parental Routes

A

Passive absorption
oral administration
inhalation
nebulisation
sublingual
topical
buccal
transdermal
intranasal
rectal

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7
Q

Common Abbreviations: BD, IM, IV, NSAID

A

BD = twice daily
IM = Intramuscular
IV = Intravenous
NSAID = Non-steroidal anti-inflammatory drug

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8
Q

Common Abbreviations: PGD, POM, PR, SC

A

PGD = Patient Group Direction
POM = Prescription Only Medication
PR = Per Rectum
SC = Subcutaneous

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9
Q

Drug Abbreviations: ASP, ADM, ADX, PAR

A

ASP = Aspirin
ADM = Adrenaline 1:1000 (IM)
ADX = Adrenaline 1:10,000 (IV/IO)
PAR: Paracetamol

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10
Q

Drug Abbreviations: NOO, GLG, GLU, GLX

A

NOO = Nitrous Oxide
GLG = Glucose 40% Oral Gel
GLU = Glucagon
GLX = Glucose 10% solution (IV/IO)

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11
Q

When checking drugs, what do you check for?

A

medication type, expiry type, strength/concentration, package integrity, clarity of fluid

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12
Q

Onset of effect for different routes: IV, IO, Buccal, nebulisation, sublingual, rectal, IM Subcutaneous, oral, topical

A

IV/IO = Immediate
Buccal = 2/3 mins
Nebulised = 2/5 mins
Sublingual = Approx 3 mins
Rectal = 5-30 mins
IM = 10-20 mins
Subcutaneous = 15-30 mins
Oral = 30+ mins
Topical = hours

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13
Q

What can effect the effectiveness of nebulisation?

A

the number of droplets
particle size
rate & depth of patient breathing

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14
Q

Advantages of nebulisation

A

rapid onset utilising bronchial mucus
reduced systemic side effects
available in a variety of presentations

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15
Q

What does oxygen flow need to be to atomize the drugs in a nebuliser

A

6-8L/min

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16
Q

How to administer rectal medication

A

try and get a chaperone
1. separate buttocks to expose rectum
2. gently insert syringe tip into rectum
3. slowly count to 3 while gently pushing plunger in until it stops
4. Count to 3 before removing the syringe from the rectum
5. count to 3 whilst holding the buttocks together to prevent leakage

17
Q

Key points when doing an IM injection

A

well perfused muscle
3-4ml
21 or 23 gauge needle

17
Q

If injecting into to deltoid site where should the needle go?

A

2.5cm from acromial process and midpoint of the lateral aspect of the arm

18
Q

How much can be injected into dorsogluteal site?

A

up to 4ml

19
Q

How to draw up a drug for IM administration

A

Wash hands & PPE

Attach a blunt fill needle to the syringe

take the cover off of this fill needle and draw up the drug from its packaging

remove the drawing up needle from the syringe and place it in a sharps bin

Attach a 21 or 23 gauge needle to the syringe

expel any air and access medication and tap the syringe to ensure air is removed.

20
Q

Potential complications of IM Injections

A

Infection
Pain from: needle, drug given, technique, volume of drug, speed of injection
Anaphylaxis
Nerve damage
Hitting a blood vessel

21
Q

At what rate should IM injections be administered?

A

10 seconds per 1ml

22
Q

Key points for subcutaneous injection

A
  1. medication goes into fat or connective tissue and not the muscle
  2. suitable for 1-2ml of medication
  3. 23 gauge needle
  4. elevate the subcutaneous skin by pinching the injection site
  5. with the needle bevel up, insert the needle at a 45 degree angle.
23
Q

Risks with injections

A

Lipodystrophy
Cellulitis
Necrosis
Skin Sloughing
Nerve Injury
Prolonged Pain

24
Q

How to reduce the risks associated with injections

A

Aseptic technique at all times
ensure correct dosage
use proper site of injection
use proper rate of injection

25
Q

How to administer a pressurised metred dose inhaler (PMDI)

A

explain the procedure and ask for consent
remove the cap & shake
ask the patient to sit up straight and lift their chin
ensure breathing is in coordination with the administration of the medication
ensure there is a seal around the mouthpiece with the patient’s mouth
press canister and encourage patient to breathe in slowly until lungs feel full
take inhaler out of the mouth and hold breath for 10 seconds or as long as is comfortable
encourage them to breathe out slowly
wait at least 30 seconds before a second dose
wash mouth if medication has steroids

ENCOURAGE SELF ADMINISTRATION

26
Q

Advantages of using a spacer device with a PMDI

A

Reduced Oropharyngeal deposition of the drug
improves lung deposition of the drug

27
Q

Disadvantages of using a spacer device with a PMDI

A

Needs to be kept clean
Can be awkward to carry

28
Q

What gauge are each needle used for cannulation?

A

RED - 14 gauge
GREY - 16 gauge
GREEN - 18 gauge
PINK - 20 gauge
BLUE - 22 gauge
YELLOW - 24 gauge

29
Q

Things to check on IV giving set

A

packaging integrity, expiry date, roller clamp open and closing easily, covers on each side, tubing should be kink free

30
Q

Things to check on IV fluid before administration

A

package integrity, expiry date, back number (write on PRF), clarity of fluid

31
Q

Connection Technique - IV fluids

A
  1. ensure flow control is turned OFF and appropriately positioned
  2. Remove the protective covers from giving set and fluids
  3. insert the giving set cannula into the fluid port with a twisting/pushing motion
  4. prime drip the chamber by squeezing until half full
  5. slowly open flow control to allow fluid through
  6. raise the end of the line as fluid nears to prevent accidental leakage and clow off flow control

HBCS2 (10 decks)

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