Injection Info

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Author:
Danette
ID:
144343
Filename:
Injection Info
Updated:
2012-03-28 01:44:14
Tags:
Injections
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Description:
Insulin injection notes
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  1. Rapid Insulins
    • Name Onset Peak Duration
    • Aspart 15 min 1 hour 3-5 hours
    • Lispro 15 min 1 hour 5 hours
    • Glulisine 15 min 1 hour 5 hours

    Rapid given with or before meals
  2. Short Insulins
    • Name Onset Peak Duration
    • Regular 30 min 2-4 hours 5-7 hours

    Short - only one given in IV
  3. Intermediate Insulins
    • Name Onset Peak Duration
    • NPH 2 hours 6-12 hours 16-24 hours
    • Lente 3 hours 8-12 hours 36 hours

    Intermediate can be mixed, give 2x a day
  4. Long Insulins
    • Name Onset Peak Duration
    • Glargine 1 hour No peak 24 hours
    • Detemir 3-4 hours No peak 24 hours
    • Ultralente 4-6 hours 18-24 hours 36 hours

    Long cannot be mixed, give 1x a day
  5. Intradermal needle
    • Tuberculin: 25-27 G
    • 3/8" @ 5-15o
    • Bevel up
  6. Intradermal Absorption
    Most potent, therefore injected into dermis where absorption is slowest
  7. Intradermal Indications
    Allergy testing, TB
  8. Intradermal Max Dose
    0.1 mL
  9. Intradermal Sites
    Inner forearm & upper back
  10. Intradermal Techniques
    Stretch skin taut, bevel up
  11. Subcutaneous Needle
    • 23-25 G
    • 5/8" @ 45o
    • 1/2" @ 90o
  12. Subcutaneous Absorption
    Slower absorption than IM
  13. Subcutaneous Indications
    Insulin, Heparin
  14. Subcutaneous Max Dose
    1 mL
  15. Subcutaneous Sites
    Back of arm, abdomen, thigh, scapula
  16. Subcutaneous Techniques
    • If you can grasp 2": 90o
    • If you can grasp 1": 45o
    • Thin patients: abdomen
    • Obese patients: long enough needle to get through fatty tissue
  17. Subcutaneous Injection Notes
    • Pain receptors!
    • DO NOT ASPIRATE, MASSAGE, OR RUB!!
  18. Intramuscular Needle
    • 20-22 G
    • 1 1/2" @ 90o
    • Older adults: 23-25 G
    • 1" @ 90o
  19. Intramuscular Absorption
    Fastest absorption rate due to muscle's vascularity
  20. Intramuscular Max Dose
    • Ventrogluteal: preferred site well developed & away from nerves & blood vessels; least risk (gluteus medius & minimus)
    • Vastus Lateralis: anterior lateral aspect of thigh (infants & children), pt supine
    • Deltoid: muscle not well-developed in many adults; used for small amounts
  21. Intramuscular Techniques
    • Assess muscle: should be free of tenderness, make sure there are no hardened lesions
    • ASPIRATE!!! (2-3 mL)
    • Z track: used to minimize local skin irritation by sealing med in muscle tissue. Pull skin & sub Q tissue 1.5" laterally to the side, hold, aspirate, inject (hold 10 sec), withdraw needle, THEN release skin.
  22. Intramuscular Injection Notes
    • Very obese 3"
    • Thin 1/2-1"
    • DO NOT USE DORSOGLUTEAL
  23. Intramuscular
    • 90o deep into muscle 3 mL max med
    • Gluteus: 20-23 G 1 1/2"-3" needle
    • Deltoid: 23-24 G 5/8"-1" needle
    • Never use bigger than a 1" needle & never >2 mL meds
  24. Subcutaneous
    • 45o average 15o-45o thin 90o obese
    • 25 G 5/8" needle @ 45o - usually
    • Small doses - 0.5-1 mL. If more needed, give 2 shots
    • Can use 1/2", 5/8", 1" needle
  25. Intradermal
    • 10o-15o 26 G
    • TB syringe - divided into hundredths
    • Bleb or wheal - Bevel up
  26. Heparin
    • 90o into abdomen grab skin
    • 25 G 3/8"-5/8" needle
    • Never rub
    • Never aspirate
    • Always use TB syringe
    • Avoid 2" around umbilicus
  27. Insulin
    • 5/8" needle 100 u = 1 mL
    • Give @ room temp
    • Never aspirate
    • Administer within 5 min of preparing syringe
    • Needle is permanent
    • Insulin syringe - marked in units
    • Only put insulin in an insulin syringe. NEVER give insulin in anything but an insulin syringe

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