What should your introduction to the patient consist of?
- Introduce yourself to the patient
- Check patient ID: Ask patient their name and DOB (don’t rely on wrist band details if the patient is able to converse with you)
- Explain the procedure and gain consent
- Ask/assist patient to adjust clothing
- Wash hands
What should be checked before administering injection?
- Check patient ID 2. Check drugs
What are you checking drugs for?
- Name of drug, the dose, route, time, expiry date, integrity of packaging, diluent if required
- Check drug for debris, cloudiness/discolouration in liquid drug
- Check date, time and signature of prescriber.
What equipment is needed for an intramuscular injection?
- Kidney dish
- Blunt drawing up needle
- Blunt drawing up filter needle
- Injection needles; Orange (25G), Blue (23G) and Green (21G)
- 2ml syringe
- Gauze swab
How should needle be prepared before intramuscular injection?
- Attach drawing up needle. (Filter needle for glass vial and red topped needle for plastic vial) Holding needle and drug vial vertical at eye level draw up required quantity of medication
- DO NOT RESHEATH NEEDLE. Remove needle by hand and dispose in sharps bin. DO NOT USE NEEDLE REMOVAL DEVICE ON SHARPS BIN AT THIS POINT
- Replace with blue (23G) or green (21G) needle for the patient with more considerable subcutaneous tissue
- Hold syringe vertically and expel air from syringe and prime needle ensuring correct amount of drug in syringe.
What gloves should be worn for intramuscular injections?
Non-sterile
When choosing and exposing an injection site, what should you check for?
Check for skin integrity and cleanliness. Socially clean skill does not require additional cleaning. Observe for haematoma, hardened skin recent injection site etc. Consider underlying structures and anatomy.
Warn patient that they will feel a sharp scratch.
What angle should you insert needle at in intramuscular injections?
Insert needle at 90°, swiftly but gently, to approximately 2/3 the needle length, ensuring needle tip is delivering drug to muscle layer.
What should you do after inserting the needle during intramuscular injections?
Aspirate: Insert needle at 90°, swiftly but gently, to approximately 2/3 the needle length, ensuring needle tip is delivering drug to muscle layer.
If blood is evident remove needle and apply pressure before continuing procedure with clean equipment.
If no blood is visible, slowly inject drug.
After removing the needle during intramuscular injections, what should be done with it?
Remove needle and apply safety needle device cover and dispose into the sharps bin immediately. Press on puncture site with gauze swab
Which needle should be used for intramuscular injections?
blue (23G) or green (21G) needle for the patient with more considerable subcutaneous tissue.
What needle should be used in subcutaneous injections?
orange (25G) needle
What angle should you insert the needle at during subcutaneous injections?
Insert needle at 45° degree angle, bevel up, swiftly but gently to approximately 2/3 of needle length, to ensure drug will be delivered into the subcutaneous fat and then slowly inject the drug.
Some subcutaneous injections are available in pre filled syringes, including heparin and insulin. What angle should these be injected at?
90 degrees to accomodate the short needle
When is the most likely scenario where an intradermal injection would be given?
To administer a local anaesthetic.
What needle should be used for intradermal injections?
Orange (25G) needle
What should always be expelled from the syringe before injection?
Expel any air
How does the insertion of a intradermal injection differ from subcutaneous/intradermal?
- Insert needle 15° degree with bevel up
- Do not attempt to stretch or pinch up the subcutaneous tissue
Durnig which injections should you stretch the tissue into which you are injecting?
Intramuscular
Durnig which injections should you pinch the tissue into which you are injecting?
Subcutaneous - Use thumb and forefinger to pinch up the subcutaneous tissue
What angle should you insert the needle during intradermal injections?
15 degrees with bevel up
Should you apply pressure or rub after intradermal injection?
No
