Transcript Parenteral Administration of Medication in Small

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Oral (PO)
Sublingual
Via feeding tube
› Esophagostomy
› Gastrostomy
› Jejunostomy
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Aural
Topical
Topical ophthalmic
Transdermal
Intranasal
Inhalation
Orogastric intubation
› Nebulized or
Nasogastric
volatilized
intubation
 Intratracheal
 Rectal (PR)
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o Intradermal (ID)
o Intraosseous (IO)
o Subcutaneous
o Intraperitoneal (IP)
(SC or SQ)
o Intramuscular (IM)
o Intravenous (IV)
o Intra-arterial (IA)
o Epidural/subdural
o Intracardiac (IC)
o Intramammary
Patient Factors
 Health conditions
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Drug Factors
 Type of
medication/fluid
› Symptoms
 Formulation of drug
› Absorption rate of
drug required
 Cost
Temperament
 Systemic vs. local
Ease of administration
effect desired
for client
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Does this medication require that special
precautions be followed during
administration (i.e. gloves, mask)?
› Examples?
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Potential side effects?
› Pain from injection
› Vomiting/GI upset/constipation
Intramuscular
90
Subcutaneous
45
Intravenous
25
Intradermal
Epidermis
Dermis
Subcutaneous tissue
Muscle
10–15
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The skin is made up of three layers: the
epidermis, dermis, and subcutaneous layers
› The epidermis is several cell layers thick and does not
contain blood vessels. Its thickness varies greatly
from region to region in any animal and varies from
species to species.
› The dermis is composed of blood vessels, lymph,
nerve fibers, and accessory organs of the skin (glands
and hair follicles).
› The subcutaneous layer (hypodermis) is composed of
connective tissue and contains a large amount of
fat.
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Muscle lies underneath all of these layers
Gather supplies
 Needles
 Syringe
 Medication to be injected
 Proficient person to restrain the animal
For venipuncture only:
 Cotton ball with alcohol
 Hydrogen Peroxide (optional)
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Needle gauge is determined by:
› Consistency of drug
› Route of administration
› Patient size
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At least two needles are required
› One to draw up the medication
› One to administer the medication
Why is this?
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Draw up exact amount of drug
› Can use smallest needle available
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Aspirate all drug into the syringe (out of
the needle)
› Hub loss-
Remove needle and replace with
appropriate needle
 Carefully ensure all air is out of the
syringe by slowly depressing the plunger.
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Supplied as:
› Sterilized solutions
› Powders that must be reconstituted with
sterile solution
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May be stored in:
› Vials (single or multi-dose)
› Ampules
› Fluid bags
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Common use of ID route:
› Desensitize skin
› Allergy skin testing
Skin is usually shaved before performing
an ID injection
 Drug is not dispersed throughout the
body
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A fold of skin is lifted or skin is pulled taught
and a 25- to 27- gauge needle attached
to a syringe is inserted with the bevel up
into the dermis.
› If allergy testing: A 0.1 ml volume of allergen is
injected.
› If locally anesthetizing skin: dose of drug
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The injection site will look like a translucent
lump if the injection is performed correctly.
Easiest route to perform technically
 Common use of SQ route:
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› Vaccine administration
› Fluid administration
› Pain medications, antibiotic injections, Insulin
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Absorption rate is slow compared to other
routes
› May be slower in obese animals
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Some substances are harmful if injected SC
› Example:
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Preferred site for most SC injections is the
dorsolateral region from the neck to the
hips.
› The dorsal region of the neck and back should
be avoided for drug administration.
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Cat vaccines: the _______________________
should be avoided because of the
incidence of vaccine-induced tumors.
› Feline vaccinations should be administered in
as distal a portion of an extremity as possible.
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Fold of skin is tented and the needle is
inserted at the base of the tent.
› Insert needle as if walking INTO the tent
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Aspirate
› Why?
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After injection, briefly massage skin to
facilitate drug distribution.
Appropriate route for injection of small
volumes of medication.
 Common uses of IM route:
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› Anesthetics/sedatives
 Convenient route of administration for
fractious animals
› Pain medications
› Heartworm treatment
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Generally, more painful for animals than
SC or IV.
› Why?
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Drugs are most often administered in the:
› Lumbosacral musculature lateral to the
dorsal spinous processes
› Semimembranosus/ semitendinosus muscles
of the rear leg
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In the hind limb: needle should enter the
lateral aspect of the muscle and be
directed caudally
› Why?
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Deep IM injections in the
third to fifth lumbar region
of the ___________________
are used to administer
adulticide heartworm
treatment (Immiticide®).
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Isolate the muscle between the fingers and thumb.
A 22 to 25 gauge needle attached to a syringe is
embedded in the muscle at a ______ angle.
As with a SQ injection, the needle hub is checked
for blood before administration of medication to
make certain a vessel is not inadvertently
penetrated.
› How did we do this?
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Once in the muscle, inject the medication slowly.
Massage the site for a few seconds after the
injection to help distribute the substance if possible.
› Exception:
Tissue trauma
 Pain at injection site
 Nerve damage
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Drugs and/or fluids may be injected directly
into a vein or through an IV catheter.
 IV route produces an immediate response
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› Usually given slowly
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Common use of IV route:
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Inducing anesthesia
Chemotherapeutic agents
Anti-convulsant drugs
Irritating drugs
Emergency/resuscitation drugs
Large amounts of _________ needed
Requires new needle for administration
CAT
DOG
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Cephalic
Lateral saphenous
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Cephalic
Medial saphenous
Femoral
Note: The jugular vein is used to administer
injections in small animals IF an intravenous
jugular catheter is in place.
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Expel all air bubbles from the syringe prior
to inserting into the vein.
Restrainer should occlude the vessel with
digital pressure or use a tourniquet.
Grasp the extremity and pull the skin taut in a
distal direction.
Swab the skin and hair with an alcohol-soaked
cotton ball (go with the fur).
Insert a 20- to 25- gauge needle, bevel up into
the vein.
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Usually blood enters the hub of the needle
at penetration of the vein (flash), BUT,
placement is confirmed by aspirating.
› What should we see?
› Venipuncturist: communicate to restrainer “I’m in”
› Restrainer: release pressure from the vein
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Inject the medication into the vein.
› If large volume of drug or movement of needle:
Communicate with restrainer and remove
needle
 Apply firm pressure to the injection site until
hemostasis/coagulation occurs
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Most common: Nye Tourniquet or Penrose
drain/rubber material
 Can be very dangerous if used improperly
 Goal is to visualize and palapte vein.
 Must be able to remove before injecting!
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Injecting drug outside of vein
 Hematoma formation
 Intra-arterial injection of drug
 Hitting a nerve (pain, lameness, paralysis)
 Air-embolus
 Phlebitis
 Septicemia
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