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Medical Injection Techniques &Administration
Saqib Nahdi
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Introduction
Tehnik Injeksi :1. Intra Vena
2. Intra Subcutan
3. Intra Cutan
4. Intra Muscular
Pemberian Obat secara injeksi, bioavabilitasnya lebihtinggi dibanding via oral.
Tehnik Injeksi secara psikologis mempercepatkesembuhan pasien.
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Resiko
Meningkatkan resiko infeksi Needle sharing transmits
Abscessedinfections of injection sites
Meningkatkan resiko terjadinya dosis ygberlebihan.
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Disadvantages
Scarringof the peripheral veins
Arises from the use ofblunt injecting equipment.
The darkening of the veins due to scarring and toxinbuildup produce tracks along the length of the veins and
are known as track marks.
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Track Marsk
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Disadvantages
Arterial damage Arterial pseudoaneurysms may form at injectionsites, which can rupture, potentially resulting inhemorrhage, distal ischemia, and gangrene.
Inadvertent intra-arterial injection can also resultin endarteritisand thrombosis.
Increased chance of addictionThe heightened
effect of administering drugs iv-ly can make thechances of addiction more likely.
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Depot injection
Is an injection, usually sc or im, of apharmacological agent which releases its activecompound in a consistent way over a long periodof time.
Depot injections are usually either solid or oil-based.
May be available as certain forms of a drug, such
as decanoate salts or esters. Examples : Depo Provera and haloperidol
decanoate.
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Safer injection
General guidelines on safer injecting of varioussubstances intravenously are typically based onthe following steps:
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Side Effects
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Subcutaneous (SQ)
Choose site: abdomen, lateral and anterior aspects ofupper arm or thigh, scapular area of back, or upperventrodorsal gluteal area.
Note: Avoid areas of bony prominence, major nerves, and
blood vessels. Desinfeksi dengan alkohol,
biarkan Kering..
Cubit lapisan kulit dg jari
telunjuk dan jempol
Masukkan jarum dengan
lubang menghadap ke atas 45
berat badan rata2, 90 jika
gemuk.
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Medication Administration Techniques
Release the sq tissue, andaspirateprior to injectingmedication (except insulin orheparin).
Tehnik Injeksi : slowly, remove
needle quickly, and gentlymassage site with alcohol swab.
DO NOT MASSAGE AFTER THE
ADMINISTRATION OFHEPARIN.
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Intramuscular (IM)
Aspirate, and observe forblood.
Inject medication slowly,remove needle quickly,
and gentlyapply pressureto site with dry, sterile 2 x2 gauze.
Do not massage injectionsite.
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Intramuscular
The upper arm can beused for bothintramuscular (IM) andsubcutaneous (SubQ)
injections.
Source: Smith et al., 2000, p. 387.
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Dorsogluteal (Upper Outer Quadrant)
Use if volume is 1 - 3 cc, but< 5 cc. Use a 20 - 23 gauge,1-1/2 inch needle.
Do not use this site in
children < 2 yr or emaciatedclients.
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Dorsogluteal (Upper Outer Quadrant)
Locate greater trochanter toidentify dorsogluteal site.
Locate posterosuperior spineof iliac crest.
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Dorsogluteal (Upper Outer Quadrant)
Draw imaginary linebetween trochanter andiliac spine.
Inject medicationdirectly into dorsoglutealsite at 90 angle.
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Ventrogluteal
Use if volume is 1 - 3 cc.Use a 20 - 23 gauge, 1-1/2inch needle.
Oreferred for adults&
children < 7 mo.
Identify greatertrochanter, and placepalm at site
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Ventrogluteal
Place palm on greater trochanter,and point to anterior iliac spine
Inject medication at 90 anglewithin "V" area.
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Anterolateral Thigh (Vastus Lateralis)
Use 22 - 25 gauge, 5/8 - 1 inchneedle.
This is the preferred site for infantsand children < 7 mo.
The m. vastus lateralis site of theright thigh, used for intramuscularinjections.
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Anterolateral Thigh (Vastus Lateralis)
Identify greater trochanter andlateral femoral condyle
Select site using middle thirdand anterior lateral aspect ofthigh.
Inject medication at 90 angledirectly into muscle
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Z-Track Method
Discard needle after medication is drawnup, and use new needle for injection tominimize tissue staining or irritation.
Use this method when administeringinjection in ventroglutealor dorsoglutealsites.
Displace skin to one side (laterally)before inserting needle.
Is used to prevent backflowofmedication into subcutaneous tissue
At 90 angle, aspirate.
Withdrawneedlebefore releasing skin.
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Intradermal ~ intracutan
Use a tuberculinor 1 cc syringe, 3/8 -5/8 inch needle. Amount to be injectedis usually 0.01 - 0.1 cc.
Choose site: dorsal forearm, upper backor upper chest.
Insert needle, with bevel facingupward, at angle of 10 - 15.
Slowly inject medication to form smallbleb
Inject solution to form wheal on skin
Withdraw needle quickly.
Do not massage area
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Arterial Puncture
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PROSEDUR PUNGSI VENA
Saqib Nahdi
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Peralatan Utama Pungsi Vena
Torniquet Jarum 20 G 22 G
Sistem Vacutainer 2-10 ml. Terdiri atas
tabung, jarum, dan holder. (Plain/AntiKoagulan)
Spuit/Syringe 3, 5 atau 10 ml
Sistem wing needle23, 25G.Biasanya untuk vena yang kecil pada orang tua
dan anak-anak (untuk pungsi vena dengan metodespuit)
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PERALATAN TAMBAHAN/PELENGKAP
Sarung tanganAlkohol 70%
Kapas Steril dan Kapas kering bulat.
Plester
Kursi dengan 2 lengan, tmpt tidur, mjakerja.
Tempat pembuangan.
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Posisi duduk atau berbaring yang nyaman, letakkan lengan pasien lurusdiatas meja dengan telapak tangan menghadap ke atas.
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1. Pilih vena yang besar, mudah dijangkau, elastis, rangsangsakitnya kurang, bentuknya lurus dan tidak mudah luka dan
bergerak.
2. Vena yang tepat : Vena Mediana Cubiti, Vena Cephalica, Vena
Basilica.
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Cara Memperbesar Vena
Posisi lengan diletakkandi bawah jantung.
Pemijitin/ pengurutan karah torniquet.
Daerah vena ditepuk-tepuk.
Kompres handukhangat/ rendam airhangat.
Membuka dan menutuptelapak tangan.
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Pasang Tourniqet
Tidak terlalukencang
Lama pemasangan
2-3 inchi diatas venayang akan di pungsi.
Bila pungsi venatertunda- lepas dan
pasang kembali.
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Desinfeksi
Kapas Alkohol 70% tunggu sampai kering.
Cara usap satu kali.
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Tusuk jarum-vena-lubang jarummenghadap ke atas dan sudut 15-30
Periksa jarum
Pegang spuit menggunkan
tangan kanan.
Tusuk, sudut 15-30
Tegangkan kulit dg ibu
jari dan telunjuk jari kiri
(fiksasi)
Saat darah sudah
tampak,aspirasi dan lepas
touniqet segera
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Menggunakan Vacutainer
Pegang jarum pada bagian tutup yg berwarna dg
satu tangan, kemudianputardan lepaskanbagian
berwarnaputihdengan tangan lainnya.
Pasangkan jarum pada holder, biarkan tutup yangberwarna tetap pada jarum.
Bila posisi pungsi telah siap, lepaskan tutup jarum
yangberwarna . Lakukanlah pungsi vena seperti
biasa.
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Tarik jarum pelan2, tekan dengan kapas
kering dan plester.
LENGAN JANGAN DITEKUK