Injections

Introduction

• Introduce
• Patient ID
• Explain and gain consent
• Ask patient to adjust clothing
• Wash hand

Check prescription and drug

• Drug
• Dose
• Route
• Time
• Expiry date
• Integrity of packing
• Debris/cloudiness/discolouration
• Date, time and signature of prescriber
• ALLERGIES

Equipment

• Kidney dish
• Blunt drawing up needle
• Correct injection needle
• Syringe
• Gauze

Example calculation

I want an injection 2ml of 0.5mg/ml of Drug X. You have a vial of 5mg/ml of Drug X and saline

$2ml\ast 0.5=1mg$ required

So need 0.2ml of the vial containing the drug

0.2ml of Drug X plus 1.8ml of saline

Intramuscular

Blue (23G) or green (21G) needle

1. Hold syringe vertically and expel air
2. Choose site - visibly clean skin does not required additional cleaning. Observe for haematoma, harened skin, recent injection site etc. Slightly anterior mid lateral deltoid
3. Stretch the skin to one side with finger
4. Warn the patient
5. Insert the needle at 90$°$ to approx 2/3 the length
6. Aspirate - if blood is present remove the needle and apply pressure
7. If no blood inject, dispose of needle and pressure on site with gauze
8. Observe for localised and systemic reaction
9. Wash hands
10. Document the procedure

Subcutaneous

Orange (25G) needle

1. Hold syringe vertically and expel air
2. Choose site - visibly clean skin does not required additional cleaning. Observe for haematoma, harened skin, recent injection site et
3. Pinch the skin
4. Warn the patient
5. Insert the needle at 45$°$ to approx 2/3 the length and slowly inject
6. Do not apply presscarure or rub
7. Observe for localised and systemic reaction
8. Wash hands
9. Document the procedure