Parenteral Medication Injection Types & Precautions

Parenteral Medication Administration

• Parenteral administration involves injecting a drug into body tissues.

Injection Sites

• Intradermal (ID): Injection into the dermis, just below the epidermis.
• Subcutaneous (SC): Injection into subcutaneous tissue, below the skin.
• Intramuscular (IM): Injection into a muscle.
• Intravenous (IV): Injection into a vein.
• Other parenteral routes include intratecal, intraespinal, intracardiac, intrapleural, intra-arterial, intraosseous, and intra-articular injections.

General Precautions

• Confirm materials are in good condition, clean, and sterile.
• Verify medication and dosage against the medical order.
• Do not mix substances that may interact.
• Avoid administering medications with altered color or consistency, or illegible labels.
• Consult with a healthcare provider if the order is unclear.
• Do not administer medications without a signed medical order.
• Administer and document every medication given.
• Check for allergies and potential adverse reactions.
• Change injection site if a blood vessel is punctured.
• Document and report any abnormal reactions.
• Clean a wide area before injecting medication.
• Alternate injection sites for consecutive injections.
• Use appropriate syringe size for the liquid volume.
• Use 18-20 gauge needles to withdraw liquid from a vial.
• Match needle size to the solution's consistency and the patient's physical build.

Syringe Parts and Needle Gauges

• Includes the plunger, cylinder, base, body, and bevel.

Preventing Infection During Injection

• Extract medication from ampoules quickly and avoid leaving it open.
• Prevent needle contamination by avoiding contact with non-sterile surfaces.
• Protect the syringe's body and plunger; keep the needle covered.
• Clean skin with soap and water, followed by an antiseptic solution in a circular motion from the center outwards, covering a 5 cm radius.

Intradermal Medication Administration

• Definition: Injecting a minimal amount (0.01 ml) of solution into the dermis for slow, local absorption.

Objectives

• Administering vaccines for immunization or desensitization.
• Performing diagnostic tests for allergies or specific diseases, producing local effects.

Equipment

• Includes a cart with tuberculin syringes with 26-28 gauge needles.
• Supplies include medication/vaccine, dry cottons, 70% alcohol (if not a vaccine), a file, medication card/prescription, pen, black and red waste bags, a glass waste container, and sterile gloves.

Actions/Steps

• Hand hygiene is required
• Prepare meds with checking all components
• Explain procedure and identify user
• Select the forearm
• Position patient and clean with alcohol
• Remove needle cap
• Stretch skin, insert needle at 10-15 degree
• Inject slowly to for a wheal that dissolves in 10-30 min
• Remove at same angle

Intradermal Scientific Basis

• Hand washing reduces microorganism transfer
• Proper preparation reduces errors
• Forearm is standard site for administering
• Cleaning reduces microorganisms

Subcutaneous Medication Administration (SC)

• Definition: Involves injecting a substance into the subcutaneous tissue.

Injection Sites

• The outer aspect of the upper arm's upper half.
• Abdomen (from below the costal margin to the iliac crests).
• Anterior thighs.
• Scapular regions of the upper back.
• Upper, ventral or dorsal gluteal areas.

Precautions

• Do not massage after administering insulin, vaccines, or other contraindicated medications.
• Avoid the dorsal gluteal region due to sciatic nerve damage risk.
• Select needle length carefully to prevent pain or muscle trauma.
• The chosen needle and insertion angle rely on the patient's weight, affecting the depth of the subcutaneous layer.
• Obese patients require a 90° insertion angle, not 45°.
• Rotate injection sites to prevent tissue damage.

Equipment

• Cart with insulin/tuberculin syringes with 23–25 gauge needles. Supplies include: medication/vaccine, dry cottons, 70% alcohol (if not a vaccine), file, prescription, black and red waste bags, glass waste container, and non-sterile gloves.

Steps

• Patient identity, provide privacy
• Relax the zone
• Make sure skin is appropriate
• Remove covering of needle
• Pre-aseptic cleanse
• Don't touch cap
• 5 right steps
• Clean inject site 5cm periphery, allow to dry and discard cotton

Intramuscular Medication Administration (IM)

• Definition: A technique for injecting a chemical or biological substance into muscle tissue.

Injection Site Characteristics

• Key locations: Gluteus maximus, Deltoid, Anterograde gluteal group, lateral vastus

Gluteus Maximus

• Risks touching sciatic nerve, trochanter, subyacent vessels
• Not for kids under 3 years and in ambulation

Deltoid

• Accessible, developed well in most
• For small amounts
• Not for children with small volumes
• Risk touches humeral

Anterograde Gluteal Group

• Deep, away from vessels and nerves
• Less contamintations, easy to find
• Absence of nerves, rapid drug absorbsion

Equipment

• Jeringas 3 y 5 ml (21,22,23)
• medicine, cotton
• 70% alcohol, file

IM Steps

• Validate medication, prepare and apply
• Validate Pt details, dose hours etc
• Uncap needle carefully, wipe, clean
• Angle slightly, aspirate need z method

Endovenous medication Adminstration

• Inject into vein

Objective

• Diagnose and treat

Precautions

• Patient supine / lay down
• Slow
• Remove needle air
• Use 5 rights

Equipment

• Alcohol, containers
• Tormiques
• Bandage, soap, gloves

Steps

• Card daily, wash hands
• Prepare and inject card
• Mask, Identify pt
• Vein clear and no varicose
• Clear needles. slow, stop compression

Overview of parenteral medication administration including intradermal, subcutaneous, intramuscular and intravenous injections. Discusses general precautions like verifying medication, avoiding interactions, and the importance of proper documentation. Covers various injection sites and safety measures.