Transcript Section 04a (Medication Routes)

Medication Routes
Advanced Care Paramedicine
Module: 6
Session: 4a
Routes
 Parenteral administration of
medications is typically done through:
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Subcutaneous
Intramuscular
Intravenous
Endotracheal
Intraosseous
Inhalation
Subcutaneous
Subcutaneous
 Prepare equipment
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Syringe
Needle
Alcohol swab
4 X 4 gauze
Medication
 Explain procedure
 Confirm allergies
 Examine medication, confirm that it is the desired
med, expiry date, cloudy/discolored?
 “Shake down” the ampule
 Break top off ampule using 4 X 4 gauze
 Draw medication into syringe and expel excess air
Subcutaneous
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Choose suitable site
Pinch up the skin
Insert needle at a 45º angle
Aspirate the syringe to
confirm placement
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If blood is aspirated,
withdraw needle and start
over
Inject medication slowly
Remove syringe and
dispose of Sharps
Apply pressure over site
Observe patient for effects
Document
Intramuscular
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Prepare equipment
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Syringe
Needle
Alcohol swab
4 X 4 gauze
Medication
Explain procedure
Confirm allergies
Examine medication, confirm that it is the desired med, expiry
date, cloudy/discolored?
“Shake down” the ampule
Break top off ampule using 4 X 4 gauze
Draw medication into syringe and expel excess air
Intramuscular
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Choose suitable site
Hold skin tight
Insert needle at a 90º angle
Aspirate the syringe to
confirm placement
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If blood is aspirated,
withdraw needle and start
over
Inject medication slowly
Remove syringe and
dispose of Sharps
Apply pressure over site
Observe patient for effects
Document
Intravenous Bolus
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Prepare equipment
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Syringe
Needle
Alcohol prep
Medication
Explain procedure
Confirm allergies
 Examine medication, confirm that it is the desired
med, expiry date, cloudy/discolored?
 Load medication
 Select appropriate IV port (closest to cannulation
site)
 Clean port with alcohol prep
Intravenous Bolus
 Insert needle into port
 Pinch off IV tubing proximal
to port
 Administer medication as
required (Bolus, Slow
IVP…)
 Release IV tubing
 Remove needle
 Monitor patient for effect
 Document
Intravenous “Piggyback”
 Prepare Equipment
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Medication
IV solution
Extra tubing
Needle
Label
Medication
 Explain procedure
 Confirm allergies
Intravenous “Piggyback”
 Prepare medication in IV solution as required
 Label medication and [ ] of drug
 Attach needle to tubing and insert into patient’s IV
port
 Tape connection to IV line for security
 Begin administration
 May need to place bag higher then the IV bag to allow
gravity to work
 Observe patient for desired effect
 Document
Endotracheal
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Prepare equipment
Hyperventilate the patient
Remove BVM for ETT
Inject medication directly into ETT
Flush if Required
Replace BVM and ventilate
Monitor patient for desired effect
Intraosseous
 Follow same procedures as IV
administration