SC/IM injection Flashcards
What does IM injection allow for?
deposited into vascular muscle tissue, through the epidermis, dermis and subcutaneous layers, which allows for rapid absorption into the circulation
Type of meds for IM?
soluble, used in small amounts and do not irritate soft tissues.
Examples of MEDS
Vaccines
Antibiotics
Anti-emetics
Analgesics
Sedatives
Amount that can be administered?
Up to 4mls into large muscles (adult thigh / buttock)
Up to 2mls into smaller muscles (adult deltoid)
Commonly used needle sizes?
21g (green), 2.5 – 5 cm long
23g (blue), 2.5 – 5 cm long
Main injection sites for IM?
- Upper arm - deltoid (1ml)
- Upper outer quadrant - dorsogluteal site (1-4ml)
- Lateral aspect of thigh - Vastus lateralis (1-5ml)
- Ventrogluteal site - gluteus medius (1-2.5ml)
Risks and complications of IM:
Pain
Bleeding (increased risk if patient is receiving anticoagulant therapy or has a clotting disorder)
Infection
Abscess formation
Nerve damage
Vessel damage
Inadvertent subcutaneous injection
Repeated injections at the same site may result in local fibrosis
The majority of complications following an IM injection are related to the drug injected.
Contraindications
Patient refusal
Infection, inflammation, lesions or broken skin at the injection site
Vascular insufficiency, poor blood supply, or oedema to the injection site
Relevant drug allergy (check!!!!)
How to do an IM injection?
Hand wash
PPE
Drug mix
new needle
locate site
assess
clean skin - dry completely
Z track
90 degrees
inject slowly (1ml per 5-10sec)
remove - sheath - pressure
dispose of needle
record onto prescription sheet
check patients welfare
What would you assess the injection site for?
signs of inflammation, oedema, infection and skin lesions
What must you do at DG site?
Pull back plunger, if blood is seen, remove the needle and syringe and apply pressure to the site until haemostasis has been achieved. Start again with a fresh set of equipment.
Why apply pressure after needle?
Applying pressure may help preventing haematoma formation.
Aftercare of IM injection?
Monitor your patient and look for any localised signs such as redness, bleeding, swelling or pain.
Observe the patient for a minimum of 15 minutes following an injection for any signs of a drug reaction.
What type of injection is SC?
allows a slow, sustained absorption of the drug as there is less blood flow to fatty tissue.
Type of meds?
must be highly soluble to prevent irritation of the soft tissues.
Example meds of SC?
Low molecular weight heparin
Insulin
Opioids such as morphine
Anti-allergy medication
max volume of meds via SC injection?
2ml
sites for SC injection
Lateral or posterior aspect of the lower part of the upper arm
Thighs
Abdomen (umbilical region)
Needle colour?
Orange
SC injection steps
Handwash
PPE
Drug mix
discard/get new needle
locate/assess site
clean skin
pinch skin into a fold
insert needle at 45 (except insulin at 90)
remove needle and apply pressure
record drug admin on prescription sheet
Why fold skin for SC injection?
This action will elevate the subcutaneous tissue and lift it away from the underlying muscle layer.
After care of SC?
Monitor your patient and look for any localised signs such as redness, bleeding, swelling or pain.
Observe the patient for a minimum of 15 minutes following an injection for any signs of a drug reaction.
