Injections Flashcards
What are 5 Ds to check before giving any drug?
Date Dose Drug Damage Dose
What 2 things beside the 5 Ds should be checked before giving any drug?
Contraindications - blood-thinning or bleeding disorders
Allergies
If you have a sharp who is responsible for disposing it?
You are
Where should you dispose of a sharp?
Sharp bin
When should you dispose of a sharp?
ASAP
Should you pass a sharp to another person?
No
What are the 4 steps to take after a needle stick injury?
Bleed the site
Wash the site
Cover it
Report it
What are subcutaneous injections?
Injected between the fat and muscle of the skin
What are 3 key characteristics of subcutaneous injections?
Slow releasing
Small volumes
Water-soluble drugs only
What are 3 examples of contraindications of subcutaneous injections?
No infection, oedema or poor perfusion
Where are the 3 sites for subcutaneous injections?
Side of the arm
Front of the thigh
Umbilical region
What does gauge refer to in terms of needles?
The diameter of the needle
What is the range of gauge for needles and what do they mean?
Normally range from 22-25G. The higher the number, the smaller the gauge
What 3 things determine the needle selection?
Patient size, age
Skin density
What 3 things impact drug absorption?
Blood flow to skin
Exercise
Environmental temperature
What is aspirating?
Drawing back on the needle, to see if blood comes back and to ensure a blood vessel hasn’t been hit
What is the appropriate angle of injection?
45 (minimal fat) - 90 degrees (more fat)
What are the 7 parts of the pre-procedure to perform an injection?
- Explain and gain consent
- check for allergies
- 5 D’s for drug administration
- Assemble syringe and drawing up needle and withdraw drug (no air bubbles)
- dispose drawing up needle, and apply appropriate - sized needle
- Position patient
- Check for any marks of damage to site
What are the 4 steps to prepare a patient right before injecting?
- Clean hands and gloves
- ensure site is clean
- talk about procedure
- Pinch skin, at correct angle
What are the 5 steps when injecting a patient
Inject slowly Wait up to 10 seconds to allow drug to diffuse Dispose of sharps Ensure patient is comfy Record drug administration info
What is IM and why is it used?
- Intra muscular deposited into muscle tissue
- Rapid absorption with prolonged duration of action
What volumes are used for IM injection?
1-5ml (small to larger muscles)
What are the 3 sites of IM?
Deltoid Vastus laterals (side of leg) rectus femoris (front of thigh)
How to find injection site for deltoid IM?
2cm below acromion process
Where would you give an IM injection to a child?
Vastus lateralis
How to find injection site for Rectus femoris IM?
halfway between patella and superior iliac crest
How to find injection site for Vastus lateralis?
Hands width from greater trochanter
Why would the deltoid be an unsuitable site for IM?
Can only inject up to 1ml at deltoid
What is Z-tracking and why is it done?
Stretch the skin before and whilst inserting needle. Stretches the skin so the entrance site is covered when the skin moves back
What are 3 advantages of Z-tracking?
- minimise leakage of drug at site
- minimise pain
- less side effects
What should be done if you have a needle stick injury?
bleed site, wash site, cover it, report it, seek support for you and the patient
What are 3 different types of drug presentation?
pre-filled
vial
powdered
fluid bag
What are 3 different routes of drug administration?
IM
IV
subcutaneous
oral
What factors are considered in needle size selection?
patient size
skin density
muscle mass
patient weight
What are possible complications of subcutaneous or IM injections?
abscesses
lipohypertrophy
bleeding
pain
What factors can impact drug absorption?
blood flow to the skin
exercise
environmental temperature
What are contraindications to a site selection?
oedema
inflammation
poor perfusion
infection
Can you identify the medicine legislation that allows paramedics to assess and administer medications?
schedule 17 and schedule 19
misuse of drugs regulations
patient group directives
What is the red needle for?
drawing up needle
What is the green needle for?
largest needle for muscular guys or fat
What is the blue needle for?
Medium size, overall good for all
What is the orange needle for?
Smallest needle for peadiatrics or subcutaneous
