Chapter 54 Administering Injections and Immunizations Copyright ©2012 Delmar, Cengage Learning. All...

Chapter 54

Administering Injections and Immunizations

Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Parenteral Injectable Medication

• Indications for parenteral routes– Patient is unable to tolerate medication by mouth– Other routes do not provide the desired effect

quickly enough– Oral medications would be destroyed by the GI

tract– Continuous delivery is required


Injection Types

• Medical assistants typically administer injections by the following routes:– Intradermal– Subcutaneous– Intramuscular


IV Medications

• Medical assistants are not permitted by provide direct IV injections or start an IV

• It is important to be able to recognize a problem and report it to the provider immediately


NeedlesParts of a Needle Needle Gauges and Sizes


Needles

• Different needles used for various routes of administration


Syringes

• The parts of a syringe


Syringes

• Sizes of syringes


Medication Containers

• Ampules and vials• Cartridge units• Single-dose, prefilled disposable syringe and

cartridge unit• Powdered medication to be reconstituted


Needle Safety

• Handling and disposing needles safely• Use needle safety devices• What to do in the event of a needlestick


Preparing the Patient

• Explain the procedure and ensure patient comfort– Special considerations for children

• Ensure immunization forms are signed• Prepare the skin


Angles of Injection


Intradermal InjectionsNeedle size: 26G or 27G, ⅜ - ⅝ inch long

Angle of injection: 10-15 degreesMedication amount given: 0.01 to 0.05 mL

Medications given: Tuberculin skin tests, allergy testingCommon sites of injection: Anterior forearm, mid-back areas


Intradermal Injections

• A small wheal should develop at the site of the injection – Record: speed of the reaction, size of the wheal– Observe the patient about 20 minutes (or longer) for any

reaction


Subcutaneous InjectionsNeedle size: 25G to 27G, ½ to ⅝ inch

Angle of injection: 45 degreesMedication amount given: Less than 2 mL

Medications given: InsulinsCommon sites of injection: Upper outer part of the arm,

abdominal area, or upper thigh


Intramuscular InjectionsNeedle size: 18G to 23G, 1 to 3 inches

Angle of injection: 90 degreesMedication amount given: 0.5 to 3.0 mL

Medications given: Narcotic pain medications, loading dose of antibiotics

Common sites of injection: Deltoid, gluteus medius, ventrogluteal, and vastus lateralis


Z-Track IM Method

• This technique prevents the medication from following the path of the needle and leaking out into the tissues

• Used for injecting substances that may be irritating or cause discoloration of the subcutaneous tissues

• Do not massage the injection site after administration


Injections and Children

• Considerations– Needle length: The size of the child’s arm or leg

will help to decide the size of the underlying muscle, which determines the needle length appropriate for the muscle thickness.

– Needle gauge: Determined by the viscosity of the medication.

– Injection site: The vastus lateralis is the preferred injection site for infants and young children


Immunizations

• Natural immunity: After recovery from exposure to certain illnesses, antibodies are generated

• Artificial immunity: Produced by administering immunizations or vaccines that trigger an immune response in the body, which in turn stimulates the production of antibodies


Types of Vaccines

• Live attenuated (changed) pathogens– Examples: varicella and measles

• Pathogenic toxin– Examples: diphtheria and tetanus

• Killed pathogen– Examples: pertussis (whooping cough), rabies, and

poliomyelitis


Vaccine Schedules

• The CDC publishes annual immunization schedules for children and adults

• The most current schedules can be downloaded from www.cdc.gov/vaccines


http://www.cdc.gov/vaccines

Preparing for Immunization

• Every patient or parent of a minor patient must be made aware of the benefits and risks of all vaccines

• A signed copy of the VIS is put in the patient’s permanent record

• Authorization forms should be in order before immunizations are administered


Illnesses Reduced by Immunization

• Influenza• Pneumonia• Haemophilus influenza type B (Hib, HIB)• Measles, mumps, and rubella (MMR)• Diphtheria



• Pertussis (whooping cough)• Rabies• Tetanus• Rotavirus• Varicella zoster (chicken pox)



• Hepatitis A• Hepatitis B• Human papillomavirus (HPV)• Meningitis• Polio


Chapter 54 Administering Injections and Immunizations Copyright ©2012 Delmar, Cengage Learning. All...

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