Injections, IVs, and ECGs Flashcards
Indications for an IM injection?
Administer medication or vaccination to be absorbed by muscular vasculature
contraindications to IM injection
allergy to substance being injection infected area (cellulitis)
For IM No more than ___ mL in infants and small children
1 mL
For IM injections No more than ____ mL in older children and small adults
2 mL
THe larger the volume of medication…..
larger the selection muscle
preferred site for IM injections for infants
vastus lateralis
in a young child how should you angle the needle in an IM injection?
perpendicular to the thigh
in infants for an IM injection how do you angle the needle?
45 degree angle
most important thing to know with injection
Aspirate it, if blood comes up don’t inject it
what is a deeper site for IM that is generally less painful?
ventrogluteal muscle
how to give an injection in the ventrogluteal muscle
Place your palm over the greater trochanter with the index finger over the ASIS and the middle finger over the posterior iliac crest (makes a V shape)
Insert the needle directly into the V slightly angled to the iliac crest
what do you need to be aware of with a dorsogluteal muscle?
sciatic nerve (and some large blood vessels)
who can you no do a dorsogluteal IM injection in?
children younger than 3
how to give a dorsogluteal muscle IM?
Locate the correct spot in the upper, outer quadrant of the buttock, 6 – 8 cm below the posterior iliac crest
Draw a line between the greater trochanter and PSIS. The ideal injection site is superior and lateral to this line
what is the volume you can inject into the deltoid?
0.5-1.0 mL
where should you inject the deltoid muscle?
upper 1/3 of the muscle
The injection site should be 2 – 3 finger breadths below the lower border of the acromion process
What should you do for all IM injections?
- clean are w/ alcohol pad and let dry
- grasp muscle and spread skin w/ thumb and index finger
- Insert the needle and aspirate for blood
- If blood aspirate –> remove and insert into a different site
- insert med slowly
- remove the needle and apply pressure w/ sterile gauze
potential complications for giving IM injections?
thrombosis of blood vessels nerve damage osteomyelitis hematoma or bleeding pain/discomfort at site of injection SQ infection at site ADR to med
follow-up instructions for IM injection
Return to clinic for any persistent erythema or pain that is not resolving
indication for SQ injection
Administer medication or vaccination into vascular connective tissue below the dermis
only what type meds can be given SQ?
water soluble
0.5 mL or less
preferred sites for SQ injection
outer aspect of upper arm
anterior aspect of upper thigh
abdomen b/w inferior costal margin and superior iliac crest
if you aspirate with blood for a SQ injection what do you do?
throw out the injection and start over again
potential complications for SQ injections
Hematoma or bleeding Pain/discomfort Subcutaneous infection Thrombosis of blood vessels Nerve damage Adverse drug reactions Hypertrophy of the skin can occur with frequent injections at the same site
indication to start an IV
To gain access to a vein for administration of medication or fluids
contraindications to starting an IV
Scarring or infection at the injection site
potential complications of starting an IV
hematoma
extravasation
phlebitis
EKG indication
To help diagnose possible heart disease (coronary, valvular, or rhythm disorders)
V1 placement
4th intercostal space at RSB
V2 placement
4th intercostal space at LSB
V3 placement
midway between V2 and V4
V4 placement
5th intercostal space at MCL just below the nipple
V5 placement
anterior axillary line lateral to V4
V6 placement
mid-axillary line lateral to V5
inferior leads
II, III and aVF
RCA
lateral leads
I, aVL, V5 and V6
circumflex artery
septal leads
V1 and V2
LAD
anterior leads
V3 and V4
LAD
