Parenteral Medications
Skills Notes (3/10/11)
Parenteral Medications
*absorbed more quickly than oral meds
*b/c injections are invasive; aseptic technique must be used!
Injections:
1. Intradermally- ID 2. Intramuscularly- IM 3. Intravenously- IV 4. Subcutaneously- SubQ
1. Intradermal Injections(ID)- the administration of a drug into the dermal layer of the skin just beneath the epidermis. * Frequently used for allergy testing and tuberculosis (TB, aka PPD) screening. * Common Sites: * Inner lower arm * Upper chest * Back beneath the scapulae * Left arm is commonly used for TB screening and right for everything else * Small doses; max amount is 0.1 cc * Needle length: 3/8” – 1/2” ; gauge: 25-27 * Most common length: 25 and gauge: 1/2” * Needle inserted at 5-15 degree angle * Just under skin; can still see needle under skin * Not whole shaft is inserted * Do not rub or scratch the injection because it can disperse deeper into the tissue or out thru the needle site. 2. Subcutaneous Injections(SubQ)- beneath the layers of the skin; hypodermic * Common sites: * Outer aspect of the upper arms * Anterior aspect of the thighs * Abdomen (umbilicus 1-2 inches away) * Scapular areas of the upper back * Upper ventrogluteal area * Upper dorsogluteal area * Upper arms and thighs are used b/c they usually have good blood circulation * Used for vaccines, insulin, and heparin * Things about insulin: * Orange is universal color * Uses insulin syringe * Typical meds to mix * Newer insulins can’t be mixed, i.e. Lantus is never mixed * “Clear to Cloudy” Method only on Regular and NPH * All syringes are based on 100 units (1cc) * Ensure at least one person who can inject in an emergency * Often refrigerated and one vial is used for many patients * If open new bottle, include time and date (must be used within 30 days) * Things about heparin
Parenteral Medications
*absorbed more quickly than oral meds
*b/c injections are invasive; aseptic technique must be used!
Injections:
1. Intradermally- ID 2. Intramuscularly- IM 3. Intravenously- IV 4. Subcutaneously- SubQ
1. Intradermal Injections(ID)- the administration of a drug into the dermal layer of the skin just beneath the epidermis. * Frequently used for allergy testing and tuberculosis (TB, aka PPD) screening. * Common Sites: * Inner lower arm * Upper chest * Back beneath the scapulae * Left arm is commonly used for TB screening and right for everything else * Small doses; max amount is 0.1 cc * Needle length: 3/8” – 1/2” ; gauge: 25-27 * Most common length: 25 and gauge: 1/2” * Needle inserted at 5-15 degree angle * Just under skin; can still see needle under skin * Not whole shaft is inserted * Do not rub or scratch the injection because it can disperse deeper into the tissue or out thru the needle site. 2. Subcutaneous Injections(SubQ)- beneath the layers of the skin; hypodermic * Common sites: * Outer aspect of the upper arms * Anterior aspect of the thighs * Abdomen (umbilicus 1-2 inches away) * Scapular areas of the upper back * Upper ventrogluteal area * Upper dorsogluteal area * Upper arms and thighs are used b/c they usually have good blood circulation * Used for vaccines, insulin, and heparin * Things about insulin: * Orange is universal color * Uses insulin syringe * Typical meds to mix * Newer insulins can’t be mixed, i.e. Lantus is never mixed * “Clear to Cloudy” Method only on Regular and NPH * All syringes are based on 100 units (1cc) * Ensure at least one person who can inject in an emergency * Often refrigerated and one vial is used for many patients * If open new bottle, include time and date (must be used within 30 days) * Things about heparin