1. Smallpox Vaccine Administration  Learning Objectives Demonstrate appropriate vaccine administration techniques Demonstrate appropriate vaccine administration techniques

2. Job Description of Vaccinator (Vaccination Area) *Assure Clinic Room Supplies are Available in his/her Designated Area *Assure Forms are Completed & Signed *Provide Vaccinations *Proper Gloving & Bandaging *Assure Vaccination Card is Completed *Understand Emergency Procedure & How to Contact EMS Personnel *Know How to Contact the Float Nurse

3. Job Description of RN Vaccinator  Has Knowledge of : Clinic Flow Clinic Flow Forms Forms Vaccine Reconstitution (if necessary) Vaccine Reconstitution (if necessary) Vaccine Administration Vaccine Administration Bandaging --- “to” or “not to” Bandaging --- “to” or “not to” Site Care Site Care Emergency Procedure ---EMS Emergency Procedure ---EMS Vaccine side effects, take & adverse events Vaccine side effects, take & adverse events (using CDC pamphlet)

4. Smallpox Vaccine Administration  Use of gloves is recommended  Persons administering smallpox vaccine should be vaccinated

5. Re-Confirm  Patient Has Signed All Paper Work  Patient Has No Contraindications to Vaccine

6. Prior to Administration Prepare gauze and tape

7. Wash Hands

8. GLOVE BOTH HANDS

9. Vaccination Site Preparation  Alcohol, soap and water, or chemical agents are not needed for preparation of the skin for vaccination unless grossly contaminated  If needed, soap and water are the preferred cleaning agents  Skin must be thoroughly dry in order to prevent inactivation of the vaccine.

10. Remove needle from sterile packaging

11. Remove stopper from vial Place stopper in protected area Dip the needle into the vaccine

12. Do NOT re-dip the needle into the vaccine solution once it has touched the person’s skin.

13. Site Selection of Vaccine Administration  Skin over the deltoid muscle, non dominant arm  Do not vaccinate an old scar  Pull Skin Taut Prior to Administration

14. Proper position of hands

15. Smallpox Vaccine Administration  Apply strokes perpendicular to the skin  Prick the skin in about 3 seconds within an area of 5 millimeters  Apply sufficient pressure to visibly push down the skin 3 pricks for primary vaccination 3 pricks for primary vaccination 15 pricks for secondary vaccination 15 pricks for secondary vaccination

16. Pressure should be sufficient to visibly push down the skin

17. A trace of blood should be present after 10-20 seconds

18. If Blood Does Not Appear After 3 Pricks Repeat 3 pricks Do Not Re-Dip Needle Into Vaccine Vial

19. Dispose of used needle immediately into sharps container

20. How To Bandage Note --- There is a possibility that a policy may be to NOT bandage

21. Cover site with a 2x2 dressing and tape

22. Discard Used Gauze in Red Bag Remove Gloves Only If Contaminated With Blood &/or Become Soiled & Discard in Red Bag Discard Used Gauze in Red Bag Remove Gloves Only If Contaminated With Blood &/or Become Soiled & Discard in Red Bag Wash Hands If You Remove Gloves

23. Sign Medical Record Show Patient What a “TAKE” Looks Like