Nursing injection 101

NURSING INJECTIONS

INJECTIONS

• Is insertion into the body with a syringe • Is a way to give medication• Has a different a technique for each type• Requires standard precaution & some require

sterile technique• Can cause complications– Hematoma– Bleeding– Infection

INJECTIONS

• Type of Injections– Subcutaneous– Intradermal– Intramuscular– Intravenous (a separate lesson)– Z Track Method

SUBCUTANEOUS INJECTION

• Made into loose tissue between dermis & muscle layer• Absorption is slower that IM or IV• < 2 mL deposited• Always perform premedication assessment• Always follow 8 Rights of Administration• Given at 45 degree angle• Rotate injection site• Common sites :

– Upper arm– Anterior thighs– Abdomen

• Most common– Heparin– Enoxaparin (Lovenox)– Insulin

SQ TECHNIQUE

• Wash hands

• 2 identifiers

• 8 Rights of Administration

• Check master rotation

schedule

• Explain procedure

• Provide privacy

• Don gloves

• Expose site

• Cleanse skin (circular motion) & allow drying

• Grasp skin creating a small roll

• Insert needle @ 45 degree angle

• Inject slowly

• Withdraw needle w/gentle pressure

• DO NOT RECAP

• Remove gloves

• Wash Hands

• Provide emotional support & answer all questions as appropriate

• Education

SQ INJECTION

INTRADERMAL INJECTIONS• Into dermal layer• Small volumes usually 0.1 mL• Absorption is slow• Always perform premedication assessment• Routes:

– allergy sensitivity test– desensitization injections– local anesthetics– Vaccinations

• 15 degree angle• Sites

– on any surface– Hairless– Upper chest– Scapular– Inner forearms

ID TECHNIQUE

• Wash hands• Provide privacy• 2 identifiers• 8 Rights• Don gloves• Prepare solution

w/aseptic technique• Insert needle @ 15

degree angle bevel up

• Remove needle quickly• Do Not Wipe site

w/alcohol afterwards• DO NOT RECAP put in

sharps container• Wash hands• Provide emotional

support• Answer all question as

appropriate• Provide Education

ID INJECTIONS

INTRAMUSCULAR INJECTION

• Penetrates thru dermis and subcutaneous tissue into muscle layer

• Medication deep in muscle mass• Absorption more rapid than SQ• Site selection important• Incorrect placement may cause nerve or blood vessel

damage• Muscles free from infection or wounds• 0.5-2 mL & 0.5-1 mL for infants or children• Divide doses in amt. > 3 mL (adults)• 20-22 gauge

IM SITES

• Vastus Lateralis• Rectus Femoris• Gluteal area – dorsogluteal not used < 3yrs– Ventrogluteal < 2yrs

• Deltoid

IM TECHNIQUE• Wash hands

• 2 Identifiers

• 6 Rights

• Check agency policy if 0.1 or 0.2 mL or air

• Consult master rotation schedule• Explain procedure

• Provide privacy

• Don gloves

• Cleanse skin circular motion & allow drying

• Insert needle correct angle (90 degree) & depth

• Aspirate & then if no blood return

• Slowly inject gently w/steady pressure

• Remove needle apply gentle pressure

• Apply bandage

• DO NOT RECAP but put in sharps container

• Remove gloves

• Wash hands

• Provide emotional support & answer questions as appropriate

• Education

VASTUS LATERALIS INJECTION

IM INJECTIONS

Ventrogluteal Site Deltoid Site

Z TRACK INJECTION

• IM injection• 90 degree angle• Into dermis down to the muscle layer• Iron Dextran injections• Prevent Drug from staining or irritating

sensitive tissue

Z TRACK METHOD

• Always perform premedication assessment• Assess skin integrity• Assure skin is able to stretch ~1 inch• Wait 10 sec. after injection• DO NOT MASSAGE• Never Inject into Arm

Z TRACK METHOD

• Wash hands• 2 Identifiers• 8 Rights of Administration• Provide privacy• Don gloves• Expose dorsogluteal site• Calculate & prepare then add

0.5 mL of air• Position client• Cleanse area• Stretch skin to 1 side 1 in.

• Insert needle 90 degree angle• Aspirate & if no blood return• Gently inject med & wait 10

sec.• Remove needle allow skin to

return to its position• DO NOT MASSAGE OR RECAP

& dispose• Remove gloves• Wash hands, provide support• EDUCATE

Z TRACK METHOD

THANK YOU!