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INJECTION MED PASS DEMO

INJECTION MED PASS DEMO. 12-10 BJM. SUPPLIES NEEDED. EACH SPN IS TO GATHER THE FOLLOWING SUPPLIES 1. 1 COPY OF EACH HANDOUT 2. 1 TRASH BAG AND 4 ALCOHOL PADS 3. 1 10 OR 12 ML SYRINGE 4. 1 25G 5/8” SYRINGE 5. 1 22G 1 ½” NEEDLE 6. 1 21G 1” NEEDLE 7. 1 TB SYRINGE

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INJECTION MED PASS DEMO

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  1. INJECTION MED PASS DEMO 12-10 BJM

  2. SUPPLIES NEEDED EACH SPN IS TO GATHER THE FOLLOWING SUPPLIES 1. 1 COPY OF EACH HANDOUT 2. 1 TRASH BAG AND 4 ALCOHOL PADS 3. 1 10 OR 12 ML SYRINGE 4. 1 25G 5/8” SYRINGE 5. 1 22G 1 ½” NEEDLE 6. 1 21G 1” NEEDLE 7. 1 TB SYRINGE 8. 1 INSULIN SYRINGE -ORANGE 9. 1 3 ML SYRINGE

  3. SUPPLIES NEEDED (cont) 10. 1 STERILE WATER AMPULE 11. 1 CARPUJECT W NEEDLE 12. 1 10 CC VIAL STERILE SALINE 13. 1 VIAL DEMO HEPARIN 14. 1 VIAL PRACTI POWDER 15. 1 VIAL INSULIN R AND INSULIN NPH

  4. SUPPLIES • NEED TO HAVE INJECTAPAD OUT • ONLY SHARPS GO INTO SHARPS CONTAINERS. NOT PAPERS • IF STICK SELF, PLEASE TELL INSTRUCTOR IMMEDIATELY AND PUT DIRTY NEEDLE IN SHARPS

  5. PARTS OF SYRINGE • REVIEW PARTS OF A SYRINGE: • A. PLUNGER • B. BARREL • C. TIP • PARTS OF NEEDLE: • A. HUB- TIGHTEN NEEDLE TO TIP AT THIS POINT • B. SHAFT • C. BEVEL- HOLE AT END • MUST KEEP NEEDLE STERILE • LOOK AT PLUNGER INSIDE BARREL AND WHERE TO READ DOSE • AVOID TOUCHING INSIDE OF PLUNGER

  6. SYRINGE SIZES • DEPENDING ON AMOUNT OF MED GIVING, WILL DRIVE THE SIZE OF SYRINGE • OBTAIN APPROPRIATE SYRINGE FOR MED GIVING • READ PACKAGE. • ALWAYS USE INSULIN SYRINGE TO INSULIN MEDICATION!!!!!!!!!!!! • DO NOT GIVE ANY OTHER MEDICATION IN AN INSULIN SYRINGE • USE 10-12 ML SYRINGE TO RECONSTITUTE MEDS IF NEEDED • MOST MEDS GIVEN USING 3 ML SYRINGE

  7. SYRINGES & NEEDLES • MANY DIFFERENT STYLES, SIZES OF NEEDLES AND SYRINGES • MUST OBTAIN CORRECT SYRINGE AND NEEDLE FOR APPROPRIATE MEDICATION • BE CAREFUL WITH. ARE VERY SHARP • DO “SWOOP AND SNAP” TO RECAP CLEAN NEEDLES • NEVER, NEVER, NEVER RECAP A DIRTY NEEDLE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! • PUT SAFETY OVER OR PUT DIRECTLY IN SHARPS • LOOK AT ALL SYRINGES YOU HAVE NOW

  8. SYRINGES • LOOK AT 3 ML SYRINGE –PINK TOP, PURPLE TOP, BLUE TOP • SOME ALREADY HAVE NEEDLE, SOME DO NOT. • MUST TIGHTEN NEEDLE TO TIP • SMALLER MEASUREMENTS • CAN USE FOR 0.5 DOSE

  9. SYRINGES • LOOK AT 10/12 ML SYRINGE • USUALLY HAVE TO ADD A NEEDLE TO • MEASUREMENTS NOT TOO SMALL • CAN NOT USE FOR 0.5 MEASUREMENT

  10. SYRINGES • INSULIN • ORANGE TOP • ONLY TO BE USED FOR INSULIN & INSULIN MUST BE GIVEN WITH THIS SYRINGE • SOME ARE 50 UNITS, SOME ARE 100 UNITS • NEEDLE DOES NOT COME OFF

  11. SYRINGES • TB SYRINGE • SMALLER BARREL • SMALLER MEASUREMENTS • ONLY CAN HOLD 1 ML • TIGHTEN NEEDLE TO TIP

  12. NEEDLES • THE SMALLER THE GAUGE NUMBER, THE LARGER AROUND (DIAMETER) THE NEEDLE IS • EX: 21 G NEEDLE IS MUCH LARGER THAN A 25 G NEEDLE • LOOK AT YOUR SYRINGES: BLUE (22G) AND PURPLE (21G) TOPS MUCH LARGER THAN RED (25G) TOP

  13. INJECTION ANGLES

  14. NEEDLESIM INJECTIONS • GAUGE: 18-25 G • LENGTH: 5/8 - 1 1/2 INCHES • AMOUNT: MAX IS 3 ML • EXCEPT DELTOID SITE: 1 ML • CHILDREN: MAX IN 1 ML ANY SITE • ANGLE: 90 DEGREES • ASPIRATE: YES ( 5 SECONDS) • HOLD SKIN TAUT WHILE STICKING PT. • LIGHT PRESSURE TO SKIN AFTER ADMINISTERING MED • PRACTICE

  15. NEEDLESSQ INJECTIONS • GAUGE: 25-30 G • LENGTH: 3/8 – 1 INCH (USUALLY 5/8) • 1 INCH FOR A LARGE PT • AMOUNT: UP TO 1 ML • ANGLE: 45 DEGREES, IF CAN PINCH MORE THAN 1”: 90 DEGREES • BEVEL UP TO STICK PT • ASPIRATE: NO, ESPECIALLY ANTICOAGULANTS • PINCH SKIN WHILE STICKING PT AND RELEASE BEFORE INJECTING MEDICATION • HOLD LIGHT PRESSURE AFTER INJECTING MEDICATION TO STOP BLEEDING • PRACTICE

  16. NEEDLESINTRADERMALS • GAUGE: 25-27 G • LENGTH: 1/4 - 1/2 INCH • AMOUNT: UP TO 1 ML • ANGLE: 10-15 DEGREES • ASPIRATE: NO • BEVEL UP TO STICK PT • HOLD SKIN TAUT WHILE INJECTING PT • JUST HOLD PRESSURE TO SKIN AFTER INJECTING MEDICATION TO STOP BLEEDING • PRACTICE • SHOULD HAVE “BUBBLE” WITH MED

  17. SUBCUTANEOUS INJECTIONS • TYPES OF MEDS: • HEPARIN • LOVENOX • ARIXTRA • RUBELLA VACCINE • INSULINS

  18. SUB Q SITES • ABDOMEN: U SHAPE AROUND UMBILICUS, 2” AWAY FROM UMBILICUS • ANTERIOR THIGH • SCAPULA • POSTERIOR BICEP

  19. SQ SITES

  20. NEEDLESSQ INJECTIONS • GAUGE: 25-30 G • LENGTH: 3/8 – 1 INCH (USUALLY 5/8) • 1 INCH FOR A LARGE PT • AMOUNT: UP TO 1 ML • ANGLE: 45 DEGREES, IF CAN PINCH MORE THAN 1”: 90 DEGREES • BEVEL UP TO STICK PT • ASPIRATE: NO • PINCH SKIN WHILE STICKING PT AND RELEASE TO INJECT MEDICATION • JUST HOLD PRESSURE AFTER INJECTING MEDICATION TO STOP BLEEDING • PRACTICE

  21. SUB Q INJECTIONS • REVIEW SUB Q GRADING RUBRIC • MUST REMEMBER TO DO ALL 4 CHECKS WITH MEDICATION • CALCULATION DURING 2ND CHECK • DRAWING UP MEDICATION DURING 2ND CHECK • MUST DOUBLE CHECK AGAIN AFTER DRAWING UP DURING 2ND CHECK

  22. UNIT DOSE WORKSHEET PRN MEDS MEDS HELD FSBS 23

  23. SUB Q INJECTIONJOHN DEPP • JOHN DEPP MAR: ORDER FOR HEPARIN 8,000 UNITS SUB-Q EVERY 8 HOURS. • PULL OUT MED DRAWER FOR JOHN DEPP AND FIND HEPARIN 10,000 UNITS/ML • DUE 0800, SUB-Q, DUE TODAY, NOT BEEN GIVEN YET, NOT ALLERGIC TO , NOT EXPIRED. • END 1ST CHECK.

  24. SUB-QJOHN DEPP • 2ND CHECK • NEED: HEPARIN 8,000 UNITS • HAVE: HEPARIN 10,000 UNITS/ML (Change • DUE: 0800, SUB-Q, TODAY, NOT BEEN GIVEN YET, NOT ALLERGIC, NOT EXPIRED • WHAT IS HEPARIN? ANTICOAGULANT • APPROPRIATE DOSE? YES BLOOD WORK? PTT, PLT COUNT • CALCULATION? YES (DO CALC) NEED? 0.8 ML

  25. CALCULATION • ORDER: 8,000 UNITS • HAVE: 10,000 UNITS/1 ML • 10,000 U = 8,000 U • 1 ML X • 10,000X = 8,000 8,000 • 10,000 • X= 0.8 ML

  26. PICK APPROPRIATE SYRINGE AND NEEDLE: 3 ML, 25G, 3/8” WIPE VIAL WITH ALCOHOL BEFORE INSERTING NEEDLE. - MUST PUT AIR INTO VIAL FIRST BEFORE WITHDRAWING MED - WITHDRAWAL MEDICATION WITH PROPER AMOUNT IN SYRINGE - DOUBLE CHECK WITH MAR AND CALC CORRECT AMT IN SYRINGE - SIGN TIME TO MAR - END OF 2ND CHECK

  27. SUB-QJOHN DEPP • 3RD CHECK • NEED: HEPARIN 8,000 UNITS • HAVE: HEPARIN 8,000 UNITS (0.8 ML) • DUE: 0800, SUB-Q, TODAY, NOT BEEN GIVEN YET, NOT EXPIRED, NOT ALLERGIC • END OF 3RD CHECK

  28. SUB-QJOHN DEPP • READY TO GO TO PT ROOM TO GIVE • GATHER SUPPLIES • MED • MAR • GLOVES • ALCOHOL • BANDAID-DO NOT ROUTINELY USE

  29. SUB-Q: ADMINISTERINGJOHN DEPP • IN ROOM • WASH HANDS • ID PT: 2 IDENTIFIERS • CHECK ALLERGIES • INFORM PT • CHOOSE SITE: MUST ROTATE SITES • 4TH CHECK OF MED • GIVE INJECTION – R Abdomen • NEEDLE IN SHARPS. GARBAGE IN TRASH BIN • FINAL 5 • WASH HANDS

  30. SUB-Q: DOCUMENTATIONJOHN DEPP • MAR: INITIALS, SITE, SIGN BOTTOM MAR, DATE AT TOP OF COLUMN OF MAR

  31. UNIT DOSE WORKSHEET PRN MEDS MEDS HELD FSBS 34

  32. NEXT ORDER FOR JOHN DEPP • 1ST CHECK • NEED: HEPARIN 1,000 UNITS • HAVE: HEPARIN 1,000 UNITS/ML (USE 1,000 UNITS/ML CONCENTRATION) • DUE: 0800, SUB-Q, TODAY, NOT EXPIRED, NOT GIVEN YET, NOT ALLERGIC • END OF 1ST CHECK • FIGURE CALCULATION FOR NEXT ORDER OF HEPARIN FOR JOHN DEPP • USE CONCENTRATION OF 1000 UNITS/ML. • NEED: 1.0 ML

  33. NEW HEPARIN DOSE • 2ND CHECK • NEED: HEPARIN 1,000 UNITS • HAVE: HEPARIN 1,000 UNITS/ML • DUE: 0800, SUB-Q, TODAY, NOT EXPIRED, NOT ALLERGIC, NOT BEEN GIVEN YET. • WHAT IS HEPARIN? Anticoagulant • APPROPRIATE DOSE? LOW • NEED CALC? NO • DRAW UP MED IN CORRECT SYRINGE • DOUBLE CHECK • TIME MAR • END OF 2ND CHECK

  34. UNIT DOSE WORKSHEET PRN MEDS MEDS HELD FSBS 38

  35. NEW HEPARIN • 3RD CHECK • NEED: HEPARIN 1,000 UNITS • HAVE: HEPARIN 1,000 UNITS IN 1.0 ML • DUE: 0800, SUB-Q, TODAY, NOT BEEN GIVEN, NOT EXPIRED, NOT ALLERGIC • END 3RD CHECK

  36. NEW HEPARIN • GATHER SUPPLIES: MED, MAR, GLOVES, ALCOHOL, BANDAID • WASH HANDS • ID PT AND ALLERGIES • INSTRUCT PT • 4TH CHECK • GLOVES ON • GIVE MED APPROPRIATE SITE: L Abdomen • DISPOSE SHARPS AND TRASH • FINAL 5 • WASH HANDS

  37. DOCUMENTATION • MAR: INITIALS, SITE, SIGN BOTTOM

  38. UNIT DOSE WORKSHEET PRN MEDS MEDS HELD FSBS 43

  39. INSULINSNEED DRUG CARDS FOR • Humalog • Humulin R (Novolin R) • Numulin N (Novolin N) (NPH) • Humalog 75/25 • Humulin 70/30 (Novolin 70/30) • Lantus

  40. INCLUDE FOLLOWING INFORMATION: • Appearance of Med- Clear or Cloudy • Group- fast, long or intermediate • Onset, Peak, Duration • Administration Time • Nursing Considerations

  41. INSULIN • LOOK AT INSULIN SYRINGE • NEEDLE DOES NOT COME OFF SYRINGE • LOOK AT MEASURING SCALE • NEED A SYRINGE THAT MEASURES EACH UNIT • NO BUBBLES IN SYRINGE THAT WILL AFFECT DOSE • IF GIVING INSULIN, MUST DO BLOOD SUGAR FIRST.

  42. SYRINGES • INSULIN • ORANGE TOP • ONLY TO BE USED FOR INSULIN & INSULIN MUST BE GIVEN WITH THIS SYRINGE • SOME ARE 50 UNITS, SOME ARE 100 UNITS • NEEDLE DOES NOT COME OFF

  43. MIXING INSULINS • CLOUDY-CLEAR-CLEAR-CLOUDY • 1. AIR INTO CLOUDY • 2. AIR INTO CLEAR • 3. WITHDRAW CLEAR -NO BUBBLES • 4. WITHDRAW CLOUDY -NO BUBBLES • PRACTICE DOING. • MUST WIPE VIAL EACH TIME ENTER VIAL • CAN NOT MIX LANTUS WITH ANY OTHER INSULIN • CAN MIX R WITH N • REVIEW MIXING INSULIN CHECK LIST

  44. UNIT DOSE WORKSHEET PRN MEDS MEDS HELD FSBS 808A 0730 808A 1130 50

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