Injections.pptx

INJECTIONS VOCABULARY •Intramuscular-situated or taking place within, or administered into, a muscle • Abbreviation: IM •Subcutaneous-situated or applied under the skin • Abbreviation: SQ •Intradermal- a shallow or superficial injection of a substance into the dermis, which is located between t...

INJECTIONS VOCABULARY •Intramuscular-situated or taking place within, or administered into, a muscle • Abbreviation: IM •Subcutaneous-situated or applied under the skin • Abbreviation: SQ •Intradermal- a shallow or superficial injection of a substance into the dermis, which is located between the epidermis and the hypodermis • Abbreviation: ID •Intravenous-existing or taking place within, or administered into, a vein or veins • Abbreviations: IV INTRADERMAL INJECTIONS •Intradermal- a shallow or superficial injection of a substance into the dermis, which is located between the epidermis and the hypodermis •administer small volumes—usually 0.01 to 0.1 mL •primary use for intradermal injections is to produce a local effect (such as in allergy or tuberculin skin testing) •The ventral forearm is the most commonly used site for intradermal injection because it's easily accessible and lacks hair INTRADERMAL INJECTION SITE: FOREARM INTRAMUSCULA R INJECTIONS •Intramuscular-situated or taking place within, or administered into, a muscle •This route of administration produces more rapid systemic circulation of a medication than the subcutaneous route • a common route for administration of immunizations •The volume of medication typically administered IM is 1 to 4 mL INTRAMUSCULA R INJECTIONS: PEDIATRICS Deltoid injection site •Infants (younger than 12 months)  1″ (2.5-cm), 22G to 25G needle is adequate to penetrate the thigh muscle for most infants the vastus lateralis muscle of the anterolateral aspect of the thigh (shown on next slide) is the recommended site for injection because it provides a large muscle mass •Toddlers(12months-3 years) The vastus lateralis muscle of the anterolateral aspect of the thigh is the preferred site for IM injection in a toddler. The needle should be 22G to 25G and at least 1″ (2.5 cm) •Children (3-18 years) Vastus lateralis injection site For children ages 3 to 10, the needle length should be from 1" to 1¼" (2.5 to 3.18 cm)  children ages 11 to 18, the needle length should be 1" to 1½" (2.5 to 3.81 cm) The deltoid muscle is preferable for IM injection in children ages 3 to 18 INTRAMUSCULAR INJECTIONS: ADULTS •Needle length depends on the injection site, the patient's size, and the amount of subcutaneous fat covering the muscle •Guidelines for needle length based on site • vastus lateralis — 1″ to ½ ″ (2.5 to 3.8 cm) • deltoid — ⅝″ to 1½″ (1.6 to 3.8 cm) • dorsogluteal —½″ to 1½″ (1.3 to 3.8 cm). DELTOID INJECTION To identify the correct injection site for IM injection into the deltoid muscle, have the patient sit or stand. Find the lower edge of the acromion process and the point on the lateral arm in line with the axilla (shown right). Insert the needle 1″ to 2″ (2.5 to 5 cm) below the acromion process, usually two or three fingerbreadths, at a 90-degree angle or angled slightly toward the process. The maximum injection volume for this area is 2 mL DORSOGLUTEA L INJECTION The patient can be positioned lying on their stomach or standing up. The muscle is located in the upper outer quadrant of the buttock, approximately 5-8cm below the iliac crest. For confirmation, an imaginary line can be drawn between the posterior superior iliac spine and the greater trochanter of the femur. The maximum injection volume for this area is 4 mL VASTUS LATERALIS To identify the correct injection site for IM injection into the vastus lateralis muscle, have the patient sit or lie in a supine position. Ask the patient to flex the knee slightly and internally rotate the foot, if possible, to relax the muscle and reduce pain. Use the lateral muscle of the quadriceps group, from a handbreadth below the greater trochanter to a handbreadth above the knee (shown right). Insert the needle into the middle third of the muscle parallel to the surface the patient is lying on. The maximum injection volume for this SUBCUTANEOU S INJECTIONS •Subcutaneous injection delivers a drug into the adipose (fatty) tissue beneath the skin and above the muscle. •subcutaneous injection provides slower, more sustained drug delivery; minimizes tissue trauma; and carries little risk of striking large blood vessels and nerves •Drugs recommended for subcutaneous injection include nonirritating aqueous solutions and suspensions in 0.5 to 2 mL of fluid Insulin and anticoagulants, such as heparin and enoxaparin, are typically administered subcutaneously •The site for subcutaneous injection for children varies by the child's age and the amount of subcutaneous tissue at the injection site •The most common subcutaneous injection sites are the outer aspect of the upper arm, anterior thigh, upper hip, buttocks, upper back, and loose tissue of the lower abdomen •Don't use a site where you where you observe bruising, redness, or edema because these may be signs of infection or inflammation. Also avoid the area immediately around the umbilicus (belly button) SUBCUTANEOU S INJECTIONS •Before administering a subcutaneous injection, elevate the subcutaneous tissue at the site by grasping it firmly. Insert the needle at a 45- or 90-degree angle to the skin's surface (as shown left), depending on needle length and the amount of subcutaneous tissue at the site. •Needle of appropriate length (typically ⅓" [0.8 cm] to ⅝" [1.6 cm]) and gauge (typically 25G to 30G) RESOURCES •Lippincott: • Subcutaneous injection, ambulatory care • Subcutaneous injection, pediatric, ambulatory care • Intradermal injection, ambulatory care • Intradermal injection, pediatric, ambulatory care • Intramuscular injection, ambulatory care • Intramuscular injection, pediatric, ambulatory care •https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Intr amuscular_Injections/