Medical Administration Supplementary Materials

Medical Administration Things to ensure before administrating a medication. • • • • • • • • Mode of action of the medications. Side effects and contraindications. Check for allergies. Antagonists of the medication. Safe dosage range for medication. Interactions with other medications. Precautions to take before administrating the medication. Proper administration technique. To prevent errors • • Ensure the correct medication is given. Correct patient, dose, route, time and date. Indications for different administration routes. Route IV IM S/C S/C Butterfly I/D (intradermal) Indication • Intermediate dosing • Emergencies • Muscles have lots of blood supply. This allows for a faster onset of action compared to subcutaneous injections. • Some have depot formulations which are designed to deliver slower sustained release of medications at sites of administration over hours, days, weeks and months. • Slower and more sustained rate of absorption due to reduced blood supply in subcutaneous tissue. • Convenient when blood supply is difficult to reach. • Continuous subcutaneous insulin infusions. • Allows for multiple pre-set rates of medication delivery. • Longest absorption time of all parenteral routes. • Due to this used for local anaesthetics. Methods and sites for each injection Intramuscularly • For adults and children over 12 months: 1. Deltoid -> at midpoint. - Volume of less than 1 mL. 2. Ventrogluteal site of buttock - Has greatest thickness of the gluteus Medius and is associated with reduced likelihood of injury. - How to locate this site: 1. Position the patient in prone or semi-prone position. 2. Place palm of hand over the greater trochanter of the patient’s hip and place the thumb anteriorly. 3. Extend the index finger to touch the anterior iliac crest and point the middle finger towards the iliac crest to from a V shape. 4. Insert the needle between the index and middle fingers within the V shape. • • For children less than 12 months: - Vastus lateralis at the midpoint of this muscle. - This is the only site that can be used for this age group. Needle sizes: - Note diameter and length suitability according to age. - For adults -> 21G. - For young children 25G. Procedure: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Gather equipment and obtain consent. Check the 6 rights: patient, dose, effects and contraindications, route, allergies, time and date. Perform hand hygiene. Prepare the medication. Clean site with an antiseptic swab. Grap the site and apply tension according to the sites mentioned above. Insert the needle at a 90-degree angle. Aspirate by pulling the plunger gently without moving the needle to ensure that the needle is not lodged in a blood vessel. - If no blood appears during this, this means that it is not in a blood vessel. Injection the solution slowly then releases the tension In the skin. Dispose sharps. Monitor for bleeding. Documentation. Intravenous • • • Different medication requires different vein size, patient age, condition of skin/veins and ease if access. Always flush with either N/saline (0.9%) or sterile water injection. Ensure 25-degree angle. Subcutaneous • • • Ensure 45-to-90-degree angle. - Choose depending on the amount of subcutaneous tissue and the length of the needle. - Shorter needles at 90 while longer needles at about 45. Pinching is advised for thinner patients and when a longer needle is use in order to lift some adipose tissue away from the underlying muscles and tissues. - If this is used, release the skin once the needle is inserted to avoid injecting into compressed tissue. Do not add more than 1mL using this method as it can cause patient discomfort and cause poor absorption.