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Most commonly used syringes
1,3,5ml ,but 10, 20,50 are also available
The syringe has 3 parts what are they?
- The barrel - the outer portion
- The plunger is the inner cylindrical portion that fits snugly in the barrel, that draws up fluid.
- The tip is the portion that holds the needle.
- All syringes, have a luer slip or luer lock tip.
Tuberculin Syringe or 1 ml syringe was originally designed to administer tuberculin inoculations.
The volume should be measured on the mm scale to achieve the greatest degree of accuracy.
What are the parts of the needle? (3)
the hub, shaft and beheveled tip. The longer the bevel, the easier the needle penetration.
What is the correct needle length for delivery of the medication to the correct site? (hint: what type of injection are you giving?)
Intradermal, subcutaeous, IM, IV is used as a guide. to select the proper volume of syringe and length and gauge of needle for adult pat.
In Small children and older infants, the usual maximum volume for IM injection at one site is?
1 ml. in small infants, the muscle mass may be only be able to tolerate a vol of .5 ml using a 1/2 -inch needle. For older children the volume should be indivualized. Ped is 1 to 1 1/2 inches long depending on the assessment of the depth of the muscle mass in the child. Ped can use 31 gauge , 1/2 inch needles
The Newest tech available, the BD integra syringe system is a
a spring-loaded syring that retracts the needle into the syringe after injection. Also uses a new tech called Tru-lock tech. It allows the changing the needle between aspiration and administra, locks the syringe and needle together securely and has a very low waste space in the hub.
What are Ampules?
are glass containers that usually contain a single dose of med. The container may be scored or have a darkened ring around the neck. This marking is where the ampule is broken off.
What are vials?
Are glass or plastic containers that contain one or more doses of a sterile medication. Before use a metal lid is popped off. The amount of med you need is the amount of air you need to put in the vial first and than draw out the solution.
What are Mix o vials?
are glass container with two compartments. The lower chamber contains the drug(solute) and the upper chamber contains the drug(solvent). Between 2 chambers is a rubber stopper. A single dose of med is normally contined in the Mix o vial. At the time of use, pressure is applied on the top rubber diaphragm plunger. This forces the solvent and rubber stopper to fall into the bottom chamber,dissolving the drug.
What are the 6 rights for medication?
- Right Patient
- Right Drug
- Right Route of administration
- Right does
- Right time of administration
- Right documentation.
Preparing a med from an ampule
Move all the sol to the bottom of the ampule, flick the side of the glass container with fingers. Cover the ampule neck with a sterile swab while breaking the top off. Discard the top. Using an aspiration(filter) needle withdraw the med from the ampule. Lower the needle as solution is withdrawn from the ampule. Remove the aspiration needle from the ampule and point the needle vertically. Pull back on the plunger and push out air bubbles and little of med appears at the top. Ready to give.
Preparing med from a vial
Cleanse the rubber diaphragm of the vial of diluent with an antiseptic swab. Pull back on the plunger of the syringe to fill with the amount of air equal to the volume of solution to be withdrawn. Insert the needle or needless device through the rubber diaphragm, inject air. Withdraw the measured volume of diluent required to reconstitute the powered drug. Remove the needle from the diaphragm of the diluent container. Check it against what you are supposed to be drawn up and the type.
Preparing med in a vial that is powdered.
Tap the vial containing the powdered drug to break up the caked powder. Wipe the diaphragm with Insert the needle across device in the diaphram and inject the diluent in to the powder. Remove the syringe and needle from the rubber diaphram. Mix throughly by dissolving before drawing up the dose. Label including date, time and volume and type of diluent added expirations date and name of person. Store as needed.
Removal of volume of liquid from a vial
Calculate the vol of med required fro teh prescribed med to be administered. Cleanse the rubber diaphragm of the vial of diluent with an antiseptic pledget. Pull back on the plunger of the syringe to fill with an amount of air equal to the vol of sol to be withdrawn. Insert the needle through the rubber diaphragm, inject air. Withdraw the volume of drug required to administer the prescribed dose.
Preparing 2 meds in one syringe
can be used for preoperative or diabetes. Check the compatibilaity and expiration date of the 2 drugs. Roll the insulin bottle in the hands to warm up and mix solution. check insulin order with another qualified nurse. Cleanse the top of both vials with separate antiseptic swabs. Pull back the plunger on the syringe to an amount equal to the volume of the longer acting insulin ordered. Insert the needle through the rubber seal of the longer acting insulin bottle, inject air. do not bubble air through the insulin, it might break it up. Remove the needle and syringe. Do not withdraw insulin at this time. Pull back the plunger on the syringe to an amount equal to the vol of the shorter acting insulin ordered. Insert the needle the the rubber seal of the second bottle inject air. Invert the bottle and withdraw the volum of shorter acting insulin ordered. Wipe the med of the longer actiing insulin container again and withdraw the longer acting insulin ordered./ Remove the syringe. Withdraw and mix meds in your hand by rolling the needle. administer by subcut route.
Intradermal injections are given in....
dermal layer of skin just below the epidermis. Small volumes, usually .1 ml are injected. The absorption is slow making it the route of choice for allergy tests., local anesthetics and vaccinations.
Tuberculin syringe with 26 gauge, 1/4 inch, 38 gauge or 1/2 inch needle or a special needle and syringe for allergens.
Intradermal injections may be made on any skin surface but the site should be hairless. the upper chest, scapular areas of the back and the inner aspect of the forearms are most commonly used.
Intradermal injection method is....
- .01 - 0.5 ml. A positive -control solution using histamine and a negative control solution using saline or the diluent of the allergen are also administered.
- Insert the needle at a 15 degree angle with needle bevel upward.
Skin Prick test (SPT) method
Place a drop of each allergen in the grid on the site. A positive control solution useing histamine and a negaive control solution using saline or the diluent of the allergen are also administered. Using a lancet with a 1 mm point, prick the skin through the allergen drop. Wipe the lancet with dry gauze between each prick to prevent carry ove rthe allergen from the previous site. The SPT can be read in 10-20 min after administration .Chart the times, agents, concentrations and amount administered.
Where are subcut injections made? at a 45 degree angle
loose connective tissue between the dermis and muscle layer. Absorption is slower and rug action is genrally longer with subcut injections than with intramuscular(IM) or intravenous(IV) injections. If the circulation is adequate, the drug is completely absorbed from the tissue. No more than .5 - 2 ml can ordinarily be deposited at a subcut site. Heparin, enoxaparin and insulin are administered subcut.
What are the common sites used for subcut administration
Upper arms, anterior thighs and abdomen. Less common areas are the buttocks and upper back or scapular region.
Why is it important to rotate the injection site?
to prevent lipohypertrophy or liphypertrophy which slows the absorption rate of the insulin. Absorption is know to be fastest when administered in the abdomen, followed by the arms, thighs and buttocks.
What degree do you give the needle and what do you do with the skin before giving the needle?
Grasp the skin area of the site selected. creaste a small roll or bunch. Insert the needle quickly at a 90 degree angle and slowly inject the med. If this is a thin person grasp the skin and inject at a 45 degree angle. Apply gentle pressure when withdrawing the needle. dispose of needles.
Intramuscular injections are made by...
penetrating a needle through the dermis and subcut tissue into the muscle layer. The injection deposits the med deep within the muscle mass. Absorption is more rapid than from subcut injections because muscle tissue has a greater blood supply. Incorrect placement may make damage to the nerves or tissue.
IM syringe is... what size?
.5-2 ml for adults and infants .5-1 ml not exceeding 1 ml. One ml may be injected in the deltoid area. Other factors that influence syringe size and needle gauge include the type of med and the site of administration, thickness of subcut fatty tissue and the age of the indiv. Assess each pat . Obese pat use 1 - 1 1/2 inches. Commonly used gauges for IM are 20-22 gauge.
Commonly used spots for IM's are.... (4)
- 1.Vastus Lateralis Muscle - located on the anterior lateral thigh away from nerves and blood vessels. below the greater trochanter and one handbreadth above the knee. Preferred site for IM injections in infants. Largest mucle mass for that group.
- 2. Rectus Femoris Muscle - medial to the vastus lateralis muscle, may be used in both children and adults.
- 3. ventrogluteal - pat placed in a prone postion,supine or side lying on a flat table surface. Located by placing the palm of the ahnd on the lateral portion of the greater trochanter, the index finger on the anterior superior iliac spine, and the middle finger extended to the iliac crest. The injection is made into the centre of the V formed between the index and middle fingers with the needle directed slightly upward toward the crest of the ilium. If muscle is relaxed pain will be minimized. Point toes inward while lying in a prone position for relaxation for the needle.
- 4. deltoid muscle - quickly absorbed. draw an imaginary line across the armpit at the level of the axilla and the lower edge of the acromion. The lateral borrders of the rectangle are vertical lines parallel to the area one third.
- Aspirate a bit to see if there is any blood and if not, inject the solution at 90 degrees.
z-track method what is it?
Stretch the skin approx 1 inch to one side. Insert the needle in dorsogluteal site. Choose a needle of sufficient length to ensure deep muscle penetration. Aspirate and to see if there is blood. Gently inject the med and wait 10 sec before removing needle. Do not massage the injection site. If further injections are to be done alternate. 90 degree angle.