MTS_Medical Injection Techniques & Administration

8/13/2019 MTS_Medical Injection Techniques & Administration

1/38

Medical Injection Techniques &Administration

Saqib Nahdi


2/38

Introduction

Tehnik Injeksi :1. Intra Vena

2. Intra Subcutan

3. Intra Cutan

4. Intra Muscular

Pemberian Obat secara injeksi, bioavabilitasnya lebihtinggi dibanding via oral.

Tehnik Injeksi secara psikologis mempercepatkesembuhan pasien.


3/38

Resiko

Meningkatkan resiko infeksi Needle sharing transmits

Abscessedinfections of injection sites

Meningkatkan resiko terjadinya dosis ygberlebihan.


4/38

Disadvantages

Scarringof the peripheral veins

Arises from the use ofblunt injecting equipment.

The darkening of the veins due to scarring and toxinbuildup produce tracks along the length of the veins and

are known as track marks.


5/38

Track Marsk


6/38

Disadvantages

Arterial damage Arterial pseudoaneurysms may form at injectionsites, which can rupture, potentially resulting inhemorrhage, distal ischemia, and gangrene.

Inadvertent intra-arterial injection can also resultin endarteritisand thrombosis.

Increased chance of addictionThe heightened

effect of administering drugs iv-ly can make thechances of addiction more likely.


7/38

Depot injection

Is an injection, usually sc or im, of apharmacological agent which releases its activecompound in a consistent way over a long periodof time.

Depot injections are usually either solid or oil-based.

May be available as certain forms of a drug, such

as decanoate salts or esters. Examples : Depo Provera and haloperidol

decanoate.


8/38


9/38


10/38

Safer injection

General guidelines on safer injecting of varioussubstances intravenously are typically based onthe following steps:


11/38


12/38

Side Effects


13/38

Subcutaneous (SQ)

Choose site: abdomen, lateral and anterior aspects ofupper arm or thigh, scapular area of back, or upperventrodorsal gluteal area.

Note: Avoid areas of bony prominence, major nerves, and

blood vessels. Desinfeksi dengan alkohol,

biarkan Kering..

Cubit lapisan kulit dg jari

telunjuk dan jempol

Masukkan jarum dengan

lubang menghadap ke atas 45

berat badan rata2, 90 jika

gemuk.


14/38

Medication Administration Techniques

Release the sq tissue, andaspirateprior to injectingmedication (except insulin orheparin).

Tehnik Injeksi : slowly, remove

needle quickly, and gentlymassage site with alcohol swab.

DO NOT MASSAGE AFTER THE

ADMINISTRATION OFHEPARIN.


15/38

Intramuscular (IM)

Aspirate, and observe forblood.

Inject medication slowly,remove needle quickly,

and gentlyapply pressureto site with dry, sterile 2 x2 gauze.

Do not massage injectionsite.


16/38


17/38

Intramuscular

The upper arm can beused for bothintramuscular (IM) andsubcutaneous (SubQ)

injections.

Source: Smith et al., 2000, p. 387.


18/38

Dorsogluteal (Upper Outer Quadrant)

Use if volume is 1 - 3 cc, but< 5 cc. Use a 20 - 23 gauge,1-1/2 inch needle.

Do not use this site in

children < 2 yr or emaciatedclients.


19/38


Locate greater trochanter toidentify dorsogluteal site.

Locate posterosuperior spineof iliac crest.


20/38


Draw imaginary linebetween trochanter andiliac spine.

Inject medicationdirectly into dorsoglutealsite at 90 angle.


21/38

Ventrogluteal

Use if volume is 1 - 3 cc.Use a 20 - 23 gauge, 1-1/2inch needle.

Oreferred for adults&

children < 7 mo.

Identify greatertrochanter, and placepalm at site


22/38

Ventrogluteal

Place palm on greater trochanter,and point to anterior iliac spine

Inject medication at 90 anglewithin "V" area.


23/38

Anterolateral Thigh (Vastus Lateralis)

Use 22 - 25 gauge, 5/8 - 1 inchneedle.

This is the preferred site for infantsand children < 7 mo.

The m. vastus lateralis site of theright thigh, used for intramuscularinjections.


24/38

Anterolateral Thigh (Vastus Lateralis)

Identify greater trochanter andlateral femoral condyle

Select site using middle thirdand anterior lateral aspect ofthigh.

Inject medication at 90 angledirectly into muscle


25/38

Z-Track Method

Discard needle after medication is drawnup, and use new needle for injection tominimize tissue staining or irritation.

Use this method when administeringinjection in ventroglutealor dorsoglutealsites.

Displace skin to one side (laterally)before inserting needle.

Is used to prevent backflowofmedication into subcutaneous tissue

At 90 angle, aspirate.

Withdrawneedlebefore releasing skin.


26/38

Intradermal ~ intracutan

Use a tuberculinor 1 cc syringe, 3/8 -5/8 inch needle. Amount to be injectedis usually 0.01 - 0.1 cc.

Choose site: dorsal forearm, upper backor upper chest.

Insert needle, with bevel facingupward, at angle of 10 - 15.

Slowly inject medication to form smallbleb

Inject solution to form wheal on skin

Withdraw needle quickly.

Do not massage area


27/38

Arterial Puncture


28/38

PROSEDUR PUNGSI VENA

Saqib Nahdi


29/38

Peralatan Utama Pungsi Vena

Torniquet Jarum 20 G 22 G

Sistem Vacutainer 2-10 ml. Terdiri atas

tabung, jarum, dan holder. (Plain/AntiKoagulan)

Spuit/Syringe 3, 5 atau 10 ml

Sistem wing needle23, 25G.Biasanya untuk vena yang kecil pada orang tua

dan anak-anak (untuk pungsi vena dengan metodespuit)


30/38

PERALATAN TAMBAHAN/PELENGKAP

Sarung tanganAlkohol 70%

Kapas Steril dan Kapas kering bulat.

Plester

Kursi dengan 2 lengan, tmpt tidur, mjakerja.

Tempat pembuangan.


31/38

Posisi duduk atau berbaring yang nyaman, letakkan lengan pasien lurusdiatas meja dengan telapak tangan menghadap ke atas.


32/38

1. Pilih vena yang besar, mudah dijangkau, elastis, rangsangsakitnya kurang, bentuknya lurus dan tidak mudah luka dan

bergerak.

2. Vena yang tepat : Vena Mediana Cubiti, Vena Cephalica, Vena

Basilica.


33/38

Cara Memperbesar Vena

Posisi lengan diletakkandi bawah jantung.

Pemijitin/ pengurutan karah torniquet.

Daerah vena ditepuk-tepuk.

Kompres handukhangat/ rendam airhangat.

Membuka dan menutuptelapak tangan.


34/38

Pasang Tourniqet

Tidak terlalukencang

Lama pemasangan

2-3 inchi diatas venayang akan di pungsi.

Bila pungsi venatertunda- lepas dan

pasang kembali.


35/38

Desinfeksi

Kapas Alkohol 70% tunggu sampai kering.

Cara usap satu kali.


36/38

Tusuk jarum-vena-lubang jarummenghadap ke atas dan sudut 15-30

Periksa jarum

Pegang spuit menggunkan

tangan kanan.

Tusuk, sudut 15-30

Tegangkan kulit dg ibu

jari dan telunjuk jari kiri

(fiksasi)

Saat darah sudah

tampak,aspirasi dan lepas

touniqet segera


37/38

Menggunakan Vacutainer

Pegang jarum pada bagian tutup yg berwarna dg

satu tangan, kemudianputardan lepaskanbagian

berwarnaputihdengan tangan lainnya.

Pasangkan jarum pada holder, biarkan tutup yangberwarna tetap pada jarum.

Bila posisi pungsi telah siap, lepaskan tutup jarum

yangberwarna . Lakukanlah pungsi vena seperti

biasa.


38/38

Tarik jarum pelan2, tekan dengan kapas

kering dan plester.

LENGAN JANGAN DITEKUK

MTS_Medical Injection Techniques & Administration

Documents

Transcript of MTS_Medical Injection Techniques & Administration