Injections Flashcards
4 types of injections
Intradermal
Subcutaneous
Intramuscular
Intravenous
two indications for injections?
1) . parenteral access for improving, treating, or maintaining current illness/injury
2) . Vaccine administration
contraindications for injections (6)
medicine allergy lack of suitable site coagulopathy occlusive PVD shock impairment of peripheral absorption
Intradermal injection: absorption? effect? most common site?
slow, little systemic absorption; local effect; ventral forearm 2-3 fingerbreaths distal to antecubital space
subcutaneous injections common sites? onset?
outer arms, anterior thigh, upper buttocks; faster onset than oral
Intramuscular injections: absorption?
deposit med into muscle tissue so readily absorbed (faster than subQ but slower than IV)
four intramuscular injection sites?
1) . deltoid: lateral humerus, 2 or 3 fingerbreaths below acromion
2) . dorsogluteal (glut med): inject above and lateral to line between PSIS and greater trochanter
3) . ventrogluteal (glut med and min)
4) . vastus lateralis muscle: middle 1/3 of muscle is best
preferred intramuscular site for infants, children and adults
vastus lateralis
what type of technique is needed for all injection administrations?
ASEPTIC
5 types of medications that can be injected?
1) . single dose ampules
2) . single or multi-dose vials
3) . vial containing powder + add sterile diluent/solvent
4) . prefilled cartridge
5) . filled syringe
what three parts of an injection needle are sterile?
1) . inside of barrel
2) . shaft/tip of plunger
3) . entire length of needle
small vs large needle gauge
larger needle number means smaller diameter
SubQ needle gauge and size
25 gauge, 5/8 needle
IM needle gauge and size
18-22, 1 1/2 in needle
Intradermal needle gauge and size
26-17, 1/2 to 5/8 inches
needle gauge choice depends on what?
viscosity of fluid
how to inject intradermal?
hold forearm and stretch skin taut above injection site
if no wheal presents after intradermal injection, what do you do?
redo at least 2 inches from first site
intradermal anaphylaxis protocol
immediate epi injection and resuscitation procedures
how to inject subQ?
pinch skin around site with nondominant hand, inject at 45 degree angle, and release skin as soon as needle is in
what is important to remember when giving subQ or IM injections RIGHT BEFORE injecting med?
after needle is inserted, pull back on plunger to make sure there isn’t blood aspiration
what do you not want to do when drawing up insulin?
DONT shake the bottle prior to drawing up (can change potency of drug)
preferred site of heparin injection?
lower abdominal fat pad, 2 inches below umbilicus (between iliac crests)
what two things do you NOT do when injecting heparin?
1) . DONT aspirate to check for blood return (may cause bleeding into tissues)
2) . DONT massage injection site (can cause localized bruises/hemorrhages)
how to do IM injection?
press skin down and stretch site with thumb and index finger (pinch skin if emaciated pt), insert needle at 90 degrees, slowly inject med
what is the purpose of an air bubble in the syringe during an IM injection?
it follows the medication into the muscle, which creates an air block to prevent med tracking to subQ
whats the purpose of the Z track IM injection? what type of med is administered?
prevents leakage of med into subQ after injection; usually iron preparations
Z track is only given where on the body?
upper outer quadrant of butt
never inject more than ___ml of med in a single site when using Z track method
5ml
Peds:
subQ injected where?
IM injected where?
subQ: thigh of infants and deltoid of older kids
IM: anterolateral upper thigh and deltoid
never use ________ muscles as sites in kids <3yrs or those walking for <1yr
gluteal muscles
what type of injections do you NOT massage after?
intradermal and heparin
