Administering Medications (Including Injections) Correct dosages, medication interactions, injection techniques (IM, SC, IV), and how to minimize pain or side effects.
Administering Medications (Including Injections)
Administering medications, including injections, requires an understanding of the correct dosages, potential medication interactions, appropriate injection techniques, and methods to minimize pain and side effects. Here’s a comprehensive overview:
1. Correct Dosages
- Dosage Calculation: Dosages are typically calculated based on the patient’s age, weight, and condition. Dosage forms and concentrations vary, so accurate calculations are crucial to avoid overdosing or underdosing.
- Units of Measurement: Ensure accurate conversion between units (e.g., mg, mcg, mL).
- Route of Administration: Different routes (oral, IM, IV, etc.) may require different dosages.
2. Medication Interactions
- Types of Interactions: Drugs can interact with each other (drug-drug interactions), with food (drug-food interactions), or with existing conditions (drug-disease interactions).
- Pharmacokinetic Interactions: These affect drug absorption, distribution, metabolism, and excretion (e.g., one drug may slow the metabolism of another).
- Pharmacodynamic Interactions: These occur when two drugs have similar or opposite effects on the body, potentially enhancing or reducing efficacy (e.g., taking sedatives with alcohol increases sedative effects).
3. Injection Techniques
- Intramuscular (IM) Injection:
- Sites: Deltoid, vastus lateralis, and ventrogluteal muscles.
- Needle Size: Typically 1 to 1.5 inches, 22-25 gauge.
- Angle: 90 degrees.
- Procedure: Clean the site, insert needle quickly at a 90-degree angle, aspirate (optional based on protocol), and inject the medication slowly.
- Indications: Vaccinations, certain antibiotics, and hormonal treatments.
- Subcutaneous (SC) Injection:
- Sites: Upper arm, thigh, abdomen, and buttocks.
- Needle Size: Typically 3/8 to 5/8 inches, 25-27 gauge.
- Angle: 45 to 90 degrees (depends on the amount of subcutaneous tissue).
- Procedure: Clean the site, pinch the skin, insert the needle at the correct angle, and inject slowly.
- Indications: Insulin, heparin, and some vaccines.
- Intravenous (IV) Injection:
- Sites: Veins in the forearm, back of the hand, or other accessible veins.
- Needle Size: Depends on the vein size and medication type; typically, a 20-22 gauge catheter.
- Angle: 25 degrees.
- Procedure: Clean the site, insert the needle or IV catheter at the appropriate angle, and inject or infuse the medication.
- Indications: Emergency medications, chemotherapy, antibiotics, and hydration fluids.
4. Minimizing Pain and Side Effects
- Pre-Injection Techniques:
- Use topical anesthetics (e.g., EMLA cream) to numb the area.
- Apply ice before injection to reduce pain.
- Relax the muscle (especially for IM injections) to reduce discomfort.
- During Injection:
- Insert the needle quickly and at the appropriate angle.
- Inject the medication slowly, especially for IM injections, to reduce tissue trauma.
- Post-Injection Care:
- Apply pressure and massage (if not contraindicated) to promote absorption and reduce discomfort.
- Cold compresses can help reduce inflammation.
- For some injections (e.g., insulin), rotating injection sites can help prevent lipodystrophy (abnormal fat distribution).
5. Injection Complications and Prevention
- Infection: Use aseptic techniques, including disinfecting the skin with alcohol before injection.
- Bleeding or Hematoma: Apply firm pressure after the injection.
- Nerve Damage: Choose appropriate sites and avoid high-risk areas (e.g., the sciatic nerve in the gluteal region).
- Pain: Use proper techniques (e.g., quick needle insertion) and minimize irritation by using appropriate needle size and angle.
By mastering these principles, healthcare professionals can administer medications safely and effectively, ensuring patient comfort and minimizing the risk of adverse effects.