Parenteral Medications
Part 1
Equipment
What is meant by the term
“Sterile”?
Identify the parts of a needle and
syringe that must remain
STERILE
when preparing an injection.
Parts of a Needle
Needle Gage
Sterile Parts of the
Syringe
List three examples of how
contamination can occur while
preparing an injection.
How can contamination be avoided?
How are the following syringes
calibrated?
3 cc or 3 ml Syringe
Tuberculin or TB Syringe
Insulin Syringe
Needles are sized by gage and
length
Which is larger?
18 gauge needle
28 gauge needle
Common lengths
3/8 to 1 1/2 inches
Bevel- The slanted opening. Always go “bevel up”
Shaft-The steel part
Hub-The plastic, colored part
The best size is the smallest
needle that will do the job!
This means that the needle must be
large enough to place the medication
in the correct place without
unnecessary trauma to the site.
NEVER, NEVER, NEVER recap a dirty needle!
Dispose of it immediately in the sharps container
You MAY recap clean needles (needles that have not entered skin)
Recapping
If you must recap, use the one-handed SCOOP method
Lay the cap down and scoop the needle into the cap
Click the lid closed using the other hand but not pushing from the top
This Is Important
You need to have a healthy respect for needles.
It’s easy to stick yourself.
Describe the protocol to be
followed if you stick yourself
with a contaminated needle.
&
Working with an Ampule
Drawing up a medication from an
ampule:
•Move fluid to the bottom
•Safely open the ampule with alcohol wipe
•Break away from you
•Use a filter needle if possible
•Change needles and inject
•Demo
•http://irtreal.austincc.edu/ramgen/de
partments/ahs/emsp/mDrwAmp.smil
Use alcohol instead of 4x4
Working with a Vial
Once opened, how long can a
multi-dose vial be used assuming
that it has not been
contaminated?
Differentiate between the 2
expiration dates found on an
opened multi-dose vial.
Labeling a Newly Opened Vial
Date & Time Opened
and Your Initials:
2/5/09 @ 0930 CM
Date & Time Vial
Expires - 30 Days:
3/5/09 @ 0930
How can a multi-dose vial be
protected from contamination?
How much air is injected into a
multi-dose vial prior to
withdrawing the desired volume
of liquid?
• http://irtreal.austincc.edu/ramgen/departmen
ts/ahs/emsp/mDrwVial.smil
Immediately put new needle on or cap with sterile cap
Intramuscular
• Syringe?
– Up to 4 ml except in deltoid. No more than 1ml in deltoid
• Needle?
– 21-23g, 1-1.5” long
• Angle?
– 90 degrees
• Always aspirate for blood return
– You will be very close to blood vessels and nerves
– If you see blood return, withdraw the needle immediately
Let’s give it a try!
•Draw up 1 ml. of saline
• consider .2ml for airlock
•Prep a site
•Give an injection
•Demo
•http://irtreal.austincc.edu/ramgen/de
partments/ahs/emsp/mIM.smil
–2x2 gauze
Subcutaneous
• Syringe?
– TB or insulin syringe
• Needle?
– 25-29 g
3/8-5/8”
• Angle?
– Short needle-- 90 degrees
– Long needle-- 45 degrees
– Don’t aspirate with insulin and heparin
• Do not massage site
• Pinch up skin or hold taut
• Demo
Evidence based practice
• Research is the basis for nursing practice,
• The buzz word for this research or analysis is
Evidenced based practice.
• An example is this article on how fast to inject
heparin sq
• http://www.blackwellsynergy.com/doi/abs/10.1046/j.13652648.2001.01925.x?cookieSet=1&journalCode=ja
n
Intradermal
• Syringe?
– Tuberculin—Up to 1 ml
• Needle?
– 25-27g, ¼-1/2 “ long
• Angle?
– 10-15 degrees
– Bevel up
• Make a wheal or bleb
• Demo
Dissolving a powdered Drug:
•Common diluents
•Volume selection
•Mixing techniques
•Which do you use?
Let’s reconstitute the Practi-Powder,
prepare a dose, and actually give an
injection!
Practi
Powder
Preparing a Dose Using a
Powdered Medication
PractiPowder
• Reconstitute with 6 ml of Bacteriostatic N/S
• Each ml. of reconstituted Practi-medication
contains 500 mg of medication
• Order states administer 750 mg IM
• How much medication will you administer?
• Demo