Administering Injections and Immunizations

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Administering Injections and Immunizations 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 Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Copyright ©2012 Delmar, Cengage Learning. Injection Types Medical assistants typically administer injections by the following routes: Intradermal Subcutaneous Intramuscular Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

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

Copyright ©2012 Delmar, Cengage Learning. Needles Parts of a Needle Needle Gauges and Sizes Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Copyright ©2012 Delmar, Cengage Learning. Needles Different needles used for various routes of administration Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Copyright ©2012 Delmar, Cengage Learning. Syringes The parts of a syringe Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Copyright ©2012 Delmar, Cengage Learning. Syringes Sizes of syringes Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Medication Containers Ampules and vials Cartridge units Single-dose, prefilled disposable syringe and cartridge unit Powdered medication to be reconstituted Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Copyright ©2012 Delmar, Cengage Learning. Needle Safety Handling and disposing needles safely Use needle safety devices What to do in the event of a needlestick Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Copyright ©2012 Delmar, Cengage Learning. Preparing the Patient Explain the procedure and ensure patient comfort Special considerations for children Ensure immunization forms are signed Prepare the skin Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Copyright ©2012 Delmar, Cengage Learning. Angles of Injection Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Intradermal Injections Needle size: 26G or 27G, ⅜ - ⅝ inch long Angle of injection: 10-15 degrees Medication amount given: 0.01 to 0.05 mL Medications given: Tuberculin skin tests, allergy testing Common sites of injection: Anterior forearm, mid-back areas Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

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

Subcutaneous Injections Needle size: 25G to 27G, ½ to ⅝ inch Angle of injection: 45 degrees Medication amount given: Less than 2 mL Medications given: Insulins Common sites of injection: Upper outer part of the arm, abdominal area, or upper thigh Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Intramuscular Injections Needle size: 18G to 23G, 1 to 3 inches Angle of injection: 90 degrees Medication 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 Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

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

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

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

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

Copyright ©2012 Delmar, Cengage Learning. Vaccine Schedules The CDC publishes annual immunization schedules for children and adults The most current schedules can be downloaded from www.cdc.gov/vaccines Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

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

Illnesses Reduced by Immunization Influenza Pneumonia Haemophilus influenza type B (Hib, HIB) Measles, mumps, and rubella (MMR) Diphtheria Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Illnesses Reduced by Immunization Pertussis (whooping cough) Rabies Tetanus Rotavirus Varicella zoster (chicken pox) Copyright ©2012 Delmar, Cengage Learning. All rights reserved.

Illnesses Reduced by Immunization Hepatitis A Hepatitis B Human papillomavirus (HPV) Meningitis Polio Copyright ©2012 Delmar, Cengage Learning. All rights reserved.