Transcript Subcutaneous

Subcutaneous Intramuscular Injections
Administer and Monitor Medication in the Work
Environment
Topic 8 Subcutaneous
Administering injections
• Subcutaneous – into the fatty sc layer of
tissue under the dermis
- not as richly supplied with blood vessels
as muscle ... slower absorption
- Normally takes at least 30 mins for
absorption – can provide the sustained
effect needed with certain drugs
Administering injections
• Subcutaneous - sites include: abdomen,
arms (posterior surface), thighs (anterior
surface), and hips
- only small doses 0.5 – 1ml can be given –
pain receptors sensitive to irritating
solutions
- Body weight of the individual indicates the
depth of sc layer
SUBCUTANEOUS INJECTIONS
SPEED OF ABSORPTION
Administering injections
• Subcutaneous
What equipment do you
need?
Equipment – SC Injection
What needle should I use for
SCI injections?
25G or 27G
Orange or grey hub
Procedure
• Subcutaneous
- Perform the standard protocol for
beginning the procedure
- Attach the drawing up needle to the
syringe
If using a vial – swab top of vial with an
alcohol wipe
If using an ampoule – gently tap to
dislodge and med. above the neck
Procedure
• Subcutaneous
- snap open the ampoule – may use a
gauze square to protect your fingers from
broken glass; may need to use a file to
help snap the ampoule
- Draw up the correct amount of medication
- Remove the needle from the syringe &
dispose into sharps container
Procedure
• Subcutaneous
- attach the administration needle to the
syringe & expel air & any surplus
medication
- Transport all equipment to the client using
a kidney dish or suitable tray
- Access the injection site & when
appropriate, clean it with alcohol
Procedure
• Subcutaneous
- Allow site to dry for about 10 sec
For insulin injections, the site is not
swabbed with alcohol if it is clean
- pinch a fold of skin upwards, insert 2/3 of
the needle at a 45 – 900 angle holding the
syringe like a dart
- Inject the medication slowly & smoothly
Procedure
• Subcutaneous
- withdraw the needle smoothly
- Place an alcohol swab or gauze over the
site for a few seconds but do not massage
as this may speed up the absorption or
may cause bleeding into the tissues
especially if administering heparin
- Complete the standard protocol for ending
the procedure
Things to consider…
• Anything that interferes with the local blood
flow to tissues affects the rate of drug
absorption e.g. exercise, hot/cold
compresses to the area ... do not give sc
injection
• Do not inject into an infected area, scar,
near a bony prominence or into underlying
muscle or nerves
Things to consider…
• Avoid using any site within 5cm of the umbilicus
– proximity to large blood vessels
• Educate clients who need regular sc injections to
rotate sites within the one area (for diabetics,
this ↓s variability of insulin absorption) –
injections should be given at least 2.5cm away
from previous site & each site should not be
used again for 1 month
Things to consider…
• Insulin pens – small prefilled cartridges
loaded into a device that looks like a pen
– some are disposable, others
reloadable.
- a very fine needle is on the tip of the pen
– many are coated with silicone = less
painful injections
- Users turn a dial to select the required
dose & then press the plunger on the end
to inject the insulin
Things to consider…
• Continuous sc medications
- often used as an alternative to repeated
IV, IM or SC boluses
- Mainly used for analgesia & insulin
- Less expensive, less risks & can be used
in client’s home
- Associated with better pain control & less
sleep disturbance when compared with IV
admin.