List three examples of how contamination can occur while
preparing an injection.
How can contamination be avoided?
Needles are sized by gage and length
Which is larger?
18 gauge needle
28 gauge needle
Common lengths
3/8 to 1 1/2 inches
The best size is the smallest needle that will do the job!
This means that the needle must be large enough to place the medication
in the correct place without unnecessary trauma to the site.
NEVER, NEVER, NEVER recap a dirty needle!Dispose of it immediately in the sharps container
You MAY recap clean needles (needles that have not entered skin)Recapping
If you must recap, use the one-handed SCOOP methodLay the cap down and scoop the needle into the cap
Click the lid closed using the other hand but not pushing from the topThis Is Important
You need to have a healthy respect for needles. It’s easy to stick yourself.
Drawing up a medication from an ampule:
•Move fluid to the bottom•Safely open the ampule with alcohol wipe•Break away from you•Use a filter needle if possible•Change needles and inject•Demo•http://irtreal.austincc.edu/ramgen/departments/ahs/emsp/mDrwAmp.smil
Use alcohol instead of 4x4
Labeling a Newly Opened Vial
Date & Time Opened and Your Initials:
2/5/09 @ 0930 CM
Date & Time Vial Expires - 30 Days:
3/5/09 @ 0930
How much air is injected into a multi-dose vial prior to withdrawing the desired volume of liquid?• http://irtreal.austincc.edu/ramgen/departmen
ts/ahs/emsp/mDrwVial.smil Immediately put new needle on or cap with sterile cap
Intramuscular
• Syringe?– Up to 4 ml except in deltoid. No more than 1ml in deltoid
• Needle?– 21-23g, 1-1.5” long
• Angle?– 90 degrees
• Always aspirate for blood return– You will be very close to blood vessels and nerves– If you see blood return, withdraw the needle immediately
Let’s give it a try!•Draw up 1 ml. of saline• consider .2ml for airlock•Prep a site•Give an injection•Demo•http://irtreal.austincc.edu/ramgen/departments/ahs/emsp/mIM.smil
–2x2 gauze
Subcutaneous
• Syringe?– TB or insulin syringe
• Needle?– 25-29 g 3/8-5/8”
• Angle?– Short needle-- 90 degrees– Long needle-- 45 degrees– Don’t aspirate with insulin and heparin
• Do not massage site• Pinch up skin or hold taut
• Demo
Evidence based practice
• Research is the basis for nursing practice,• The buzz word for this research or analysis is
Evidenced based practice.• An example is this article on how fast to inject
heparin sq• http://www.blackwell-synergy.com/doi/abs/10.104
6/j.1365-2648.2001.01925.x?cookieSet=1&journalCode=jan
Intradermal
• Syringe?– Tuberculin—Up to 1 ml
• Needle?– 25-27g, ¼-1/2 “ long
• Angle?– 10-15 degrees– Bevel up
• Make a wheal or bleb• Demo
Dissolving a powdered Drug:
•Common diluents
•Volume selection
•Mixing techniques
•Which do you use?
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