Injections 💉

Question 1

What are the 3 main types of injection?

Answer 1

1. intramuscular
2. subcutaneous
3. intradermal

Question 2

What 5 steps should be carried out before performing the injection?

Answer 2

1. introduce yourself to patient
2. check patient ID by asking their name and DOB
3. explain the procedure and gain consent
4. ask/assist patient to adjust clothing
5. wash hands

Question 3

What 2 things should be checked at the patient’s bedside?

Answer 3

1. patient ID

2. characteristics of drug

Question 4

When checking the drug at the patient’s bedside, what should be looked at?

Answer 4

1. name of drug
2. dose of drug
3. route and time
4. expiry date
5. check for debris, cloudiness or discolouration
6. date, time and signature of prescriber

Question 5

What equipment is needed to perform an injection?

Answer 5

1. kidney dish
2. blunt drawing up needle or filter needle
3. injection needles (orange, blue or green)
4. syringe
5. guaze swab

Question 6

What are the 3 different types of injection needles?

Answer 6

1. orange - 25G
2. blue - 23G
3. green - 21G

Question 7

What type of gloves should be used for this procedure?

Answer 7

non-sterile gloves

Question 8

What are the 2 different types of drawing up needles used for?

Answer 8

filter needles are used for glass vials

red-topped needles are used for plastic vials

Question 9

What is the first stage in giving an injection?

Answer 9

attach the drawing up needle

hold the needle and the drug vial vertical at eye level to draw up the required amount of medication

Question 10

What should be done with the drawing up needle after the medication has been withdrawn?

Answer 10

DO NOT RESHEATH the needle

remove the needle by hand and dispose of it in a sharps bin

Question 11

What should the drawing up needle be replaced by?

Answer 11

a blue (23G) or green (21G) needle for a patient with more considerable subcutaneous tissue

Question 12

What should be done after replacing the drawing up needle with an injection needle?

Answer 12

hold syringe vertically and expel air from the syringe

prime the needle ensuring the correct amount of drug is in the syringe

Question 13

How should the skin be inspected before choosing an injection site?

Answer 13

check skin for integrity and cleanliness

observe for haematoma, hardened skin or a recent injection site

consider underlying structures and anatomy

Question 14

How should the skin be cleaned before an injection?

Answer 14

socially clean skin does not require additional cleaning

Question 15

Immediately before the injection, what should you tell the patient?

Answer 15

warn the patient that they will feel a sharp scratch

Question 16

In an IM injection, how should you insert the needle?

Answer 16

1. use thumb and forefinger to slightly stretch the skin
2. insert needle at 90 degrees quickly to approximately 2/3 of needle length

this ensures the drug is delivered to the muscle layer

Question 17

What should you do before injecting the medication into the patient?

Answer 17

aspirate

if blood is evident, remove the needle and repeat the procedure with clean equipment

Question 18

If no blood is visible after aspiration, what should be done next?

Answer 18

slowly inject the drug

more viscous solutions will take longer to administer

Question 19

After injecting the drug, what should be done to the needle and the patient?

Answer 19

remove the needle and apply safety cover

dispose of the needle in the sharps bin immediately

press on the puncture site with a gauze swab and observe for localised and systemic reaction

Question 20

How should the procedure be concluded?

Answer 20

dispose of equipment in relevant clinical waste bin

ensure the patient is comfortable

wash hands and record procedure appropriately

Question 21

Which needle should be used in subcutaneous injection?

Answer 21

orange (25G) needle

Question 22

How does the process of subcutaneous injection differ to intramuscular?

Answer 22

use thumb and forefinger to pinch up the subcutaneous tissue

insert needle at 45 degree angle with the bevel up

do this swiftly until approximately 2/3 of the needle length

Question 23

When should a subcutaneous injection be injected at 90 degrees?

Answer 23

if the injection is available in a pre-filled syringe, as the needles are shorter

e.g. heparin and insulin