Small Volume Injections

Question 1

Small volume injection

Answer 1

Injections 100 mL or less. May be single or multidose

Question 2

Intradermal (ID)

Answer 2

Below the surface of the skin
As large as 0.5 mL
1 ml syringe and 25-29 g 3/8-5/8 needle

Question 3

Subcutaneous

Answer 3

Into the fat tissue
1 mL max volume
1-3 mL syringe
25-30 gauge 1/2-5/8 inches

Question 4

Intramuscular (IM)

Answer 4

Muscle mass
5 mL maximum
20-22 g 1/2-1 1/2 inch

Question 5

Sites for IM injection and max volumes:

Answer 5

Deltoid (2 ml)
Dorsogluteal (5 mL)
Ventrogluteal
Vastus Lateralis

Question 6

Best IM muscle for children under 3

Answer 6

Vastus lateralis (1 mL max)

Question 7

Intravenous injection

Answer 7

Into the veins
1-60 mL
20-22 g, 1/2 - 1 1/2 inches

Question 8

IV Types

Answer 8

Continuous or constant infusion
Intermittent
Bolus or IV Push

Question 9

Continuous IV

Answer 9

Added to a large volume solution and slowly dripped into vein

Question 10

Continuous IV advantages

Answer 10

Fluid and drug simultaneously
Continuous, constant blood levels
Minimizes vein irritation and trauma
Cost saving

Question 11

Continuous IV disadvantages

Answer 11

Greater monitoring
If IV infiltrates, can’t be continued
Can’t be used in fluid restricted patients
Doesn’t work with unstable drugs

Question 12

Intermittent IV

Answer 12

25-100 mL given in 15-60 min at spaced intervals

Question 13

Intermittent IV advantages

Answer 13

Less monitoring
Less chance of toxicity without continuous disadvantages
Drugs are more stable at moderate concentrations than concentrated bolus

Question 14

Intermittent IV disadvantages

Answer 14

Fluids/electrolytes can’t be given this way
Blood levels are less constant
Not used for direct administration to organ/tissue
Impractical for immediate injections in emergency situations

Question 15

IV push or bolus

Answer 15

Drug administered in a syringe over a short period of time

Question 16

IV push/bolus advantages

Answer 16

Immediate injection in emergency situations
No monitoring of IV fluid administration
Less expensive than intermittent administration

Question 17

IV push/Bolus disadvantages

Answer 17

More irritating
Less stable due to concentration
Greater toxicity
Drug blood levels are less
May require more staff time with repeated doses

Question 18

Five rights

Answer 18

Right medication
Right dose
Right route
Right patient
Right time

Question 19

Priming volume

Answer 19

Drug to prime new needle being added when volume is 1 mL or less

Question 20

Mixing two or more drugs in one syringe

Answer 20

Check the doses
Check compatibility

Question 21

Method of handling dead space with small dose volumes

Answer 21

Draw proper dose in separate syringe
Remove hub cap from tip of third and add shoot doses into separate syringe