2. Parenteral Medication Administration Devices Parenteral administration –Topical and transdermal medications –Inhalers –Sublingual medications –Injections

3. Parenteral Medication Administration Devices (cont.) Administer medications by injection – Intravenous (IV) – Intramuscular (IM) – Intradermal (ID) – Subcutaneous (Subcut)

4. Standard Syringes Calibrated in milliliters (mL) Allow for measurement of small doses Are usually 3-mL

5. Standard Syringes (cont.) Zero calibration – edge of barrel near needle Leading ring - tip of plunger closest to needle Trailing ring – ring farthest from needle Click to view syringe

6. Hypodermic Syringe Plunger Needle Barrel Trailing RingLeading Ring Syringe hub Needlestick prevention safety device

7. Safety Syringes Have same components as standard syringes Include a safety mechanism Reduce the chance of needlestick injury

8. Prefilled Syringes Prefilled syringes contain a single, standard dose of medication. When using a prefilled syringe, measure the dose carefully. Discard any excess medication in a prefilled syringe prior to injection.

9. Prefilled Syringes Rule 8-3 Rule 8-3 When using a prefilled syringe, 1.examine the markings to determine whether the syringe is calibrated in milliliters or milligrams; 2.calculate the dose accordingly.

10. Insulin Syringes Insulin syringes are used only to measure and administer insulin. – U-100 insulin most common form They are calibrated in units. U-100 insulin syringes are available in 50 and 100 unit capacities.

11. Insulin Syringes (cont.) 100 Unit Insulin Syringe 50 Unit Insulin Syringe

12. Insulin Syringes (cont.) 50 unit syringe 100 unit syringe Comparison of insulin syringes:

13. Rule 8-4 Rule 8-4 Never use any type of syringe other than an insulin syringe to measure and administer insulin. Insulin Syringes (cont.)

14. Tuberculin Syringes Uses – Subcutaneous injections – Intradermal injections – Doses less than 1 mL Examples: – PPD skin test – Vaccines – Heparin – Pediatric medicines – Allergen extracts

15. Tuberculin Syringes (cont.) Calibrated in hundredths of a mL Require careful measurement –Calibrations are close together. –Carefully align leading ring with correct calibration.

16. Tuberculin Syringes (cont.) 1 mL Tuberculin Syringe 0.5 mL Tuberculin Syringe

17. Tuberculin Syringes (cont.) Comparison of tuberculin syringes: 0.5 mL syringe 1 mL syringe

18. Syringes for Established IV Lines Used to administer medication and fluids directly into a patient’s vein Use the injection port of an IV line

19. Syringes for Established IV Lines Advantages –eliminate repeated punctures –decrease risk of needlestick injuries –allow compatible drugs to be administered together –enable periodic drug delivery –enable dilution of the medication

20. Large-Capacity Syringes Syringes with 5 mL, 6 mL, 12 mL –Volume is measured in milliliters but calibrations may vary. –Look carefully at the marks to measure an accurate amount of medication.

21. Large-Capacity Syringes (cont.) 10 mL syringe

22. Error Alert! Pay close attention to the calibration of any syringe you use. – Check the marks carefully. – Always align the leading ring with the calibration.

23. Ampules, Vials, and Cartridges Cartridge Vial Ampule

24. Cartridges Prefilled container shaped like a syringe barrel One dose of medication Fits a reusable syringe Examples –Tubex ® –Carpuject ®

25. Ampule An ampule is a sealed container holding one dose of medication. It snaps open. Use a standard syringe to withdraw the medication.

26. Vials Container covered with a rubber stopper Contains one or more doses of medication May contain either liquid or powder medication

27. Preparing the Syringe Rule 8-5 Rule 8-5 In most circumstances, the person who prepares a syringe for injection should deliver the injection.

28. Preparing the Syringe Rule 8-5 Rule 8-5 Exceptions include: 1. pharmacy technicians who pre-fill syringes; 2. nurses or medical assistants preparing a syringe for a physician; 3. healthcare workers teaching a patient to administer his or her own medication.

29. Needle Gauge and Length Choose appropriate needle for injection. Gauge –The gauge is the interior diameter. –Smaller gauges correspond to larger diameters. Length is determined by the injection site.

30. Needle Gauge and Length (cont.) Type of InjectionNeedle Gauge Available Lengths (inches) Intradermal25 – 26 Subcutaneous23 – 27 Intramuscular18 – 23

31. Practice Plunger Needle Barrel Trailing RingLeading Ring D. E. F. A. B. G. C.

32. Practice Syringe hub Plunger Needle Barrel Trailing RingLeading Ring D. E. F. A. B. C. Needlestick prevention safety device G.

33. Practice You have an order to administer 1.5 mL of a medication. It comes in a 3 mL prefilled syringe. What should you do? ANSWER: Carefully check the calibration and discard the excess medication prior to giving the injection. In this case, you would discard 1.5 mL medication. You should NEVER attempt to inject the correct dose without removing the excess medication first.

34. Apply Your Knowledge Which type of delivery device is used to administer medication to the eyes and ears? ANSWER: Dropper What kind of syringe is used to deliver vaccinations? ANSWER: Tuberculin

35. Apply your Knowledge How many mL are indicated on this syringe? ANSWER: 1.6 mL