Knowing how to give injections correctly is very useful, because it is not always possible to call a nurse or go to the clinic. There is nothing difficult about doing injections professionally at home. Thanks to this article, you will be able to do them for yourself or your loved ones if necessary.
Don't be afraid of injections. After all, the injection method of administration medical supplies in many cases better than oral. With an injection, more of the active substance enters the blood without causing negative impact on the gastrointestinal tract.
Most drugs are administered intramuscularly. Some drugs, for example, insulin or growth hormone, are administered subcutaneously, that is, the drug goes directly into the subcutaneous fat tissue. Let us consider in detail these methods of administration. It should immediately be said about possible complications. If you do not follow the injection algorithms, then the following are likely: inflammation, suppuration of soft tissues (abscess), blood poisoning (sepsis), damage to nerve trunks and soft tissues. Using the same syringe to inject multiple patients contributes to the spread of HIV infection and some hepatitis (for example, B, C, etc.). Therefore, it has great importance To prevent infection, follow the rules of asepsis and carry out injections in accordance with established algorithms, including disposal of used syringes, needles, cotton balls, etc.
What is needed for intramuscular injection
Syringe 2-5 mlInjection needle up to 3.7 cm long, gauge 22–25
Collection needle medicinal product from a bottle up to 3.7 cm long, caliber 21
Tampon pre-treated in an antiseptic solution (alcohol, chlorhexidine, miramistin)
Raw cotton ball
Strip of adhesive plaster
What is needed for a subcutaneous injection
Assembled (with needle) insulin syringe (0.5-1ml caliber 27-30)Cotton ball treated with alcohol
Dry cotton ball
Band-Aid
If possible, it is necessary to place the syringe in its packaging in the refrigerator an hour before administering the solution, which will help avoid deformation of the needle during the injection process.
The room in which the injection will be performed should have good lighting. The necessary equipment should be placed on a clean table surface.
Wash your hands well with soap.
Make sure that disposable equipment packaging is sealed and that the expiration date is up to date. medicine. Avoid reusing disposable needles.
Treat the bottle cap with a cotton swab moistened with an antiseptic. Wait until the alcohol has completely evaporated (the lid will become dry).
Attention! Do not use syringes and other accessories that were not packaged or if their integrity was damaged. Do not use the bottle if it has been opened before you. It is forbidden to drive a drug that has passed its expiration date.
A set of the drug from a bottle into a syringe
#1 . Remove the syringe and attach to it a needle intended for drawing up the solution.#2 . Fill the syringe with as much air as you need to administer the medication. This action makes it easier to draw the medicine from the bottle.
#3 . If the solution is produced in an ampoule, then it must be opened and placed on the table surface.
#4 . You can open the ampoule using a paper towel, this way you can avoid cuts. When collecting the solution, do not poke the needle into the bottom of the ampoule, otherwise the needle will become dull. When there is little solution left, tilt the ampoule and collect the solution from the wall of the ampoule.
#5 . When using a reusable bottle, you need to pierce the rubber cap with a needle at a right angle. Then turn the bottle over and introduce into it the air that was drawn in before.
#6 . Fill the syringe with the required volume of solution, remove the needle and put the cap on it.
#7 . Change needles using the one you will use to inject. This recommendation must be performed if the solution is drawn from a reusable bottle, since the needle becomes blunt when piercing the rubber cap, although this is not visually noticeable. Remove any air bubbles in the syringe by squeezing them out and prepare to inject the solution into the tissue.
#8 . Place the syringe with the needle cap on a non-contaminated surface. If the solution is oily, it can be warmed to body temperature. To do this, you can hold the ampoule or bottle under your arm for about 5 minutes. Do not stand under the stream. hot water or in another way, because in this case it is easy to overheat. A warm oil solution is much easier to inject into the muscle.
Intramuscular injections
#1 . Treat the injection site with a swab soaked in antiseptic. It is best to inject the solution into the upper outer part of the buttocks or into outside hips. After treatment with a swab, you should wait until the antiseptic dries.#2 . Remove the cap from the needle, stretch the skin of the intended injection site with two fingers.
#3 . With a confident movement, insert the needle almost its entire length at a right angle.
#4 . Slowly inject the solution. At the same time, try not to move the syringe back and forth, otherwise the needle will cause unnecessary microtrauma to the muscle fibers.
When performing an intramuscular injection, it is correct to inject the solution into the area of the upper outer quadrant of the buttock.
Also suitable for injection middle part shoulder
In addition, you can inject the solution into the area of the lateral thigh. (Colored in the figure.)
#5 . Remove the needle. The skin will close, closing wound channel, which will prevent the medicine from flowing back out.
#6 . Dry the injection site with a cotton ball and, if necessary, cover with a strip of adhesive tape.
Attention! Do not insert a needle into skin, if they have mechanical injuries, pain is felt, a change in color is observed, etc. The maximum volume of solution that can be administered at a time should be no more than 3 ml. It is recommended to change the injection site to avoid getting the solution in one place more than every 14 days. If you have weekly injections, use both buttocks and thighs. When you inject in the second circle, try to move a couple of centimeters from the previous injection site. Touch with your finger, perhaps you will feel where the last injection was and inject a little to the side.
Subcutaneous injections
Treat the injection site with an antiseptic. Lower abdomen around the navel - the best place for injection. Wait for the alcohol to dry completely.The shading indicates the area of the abdomen best suited for subcutaneous administration drug.
#1 . Remove the cap. Gather the skin into a fold to separate the subcutaneous fat layer from the muscles.
#2 . Using confident movements, insert the needle at a 45-degree angle. Make sure the needle is located under the skin and not in the muscle layer.
#3 . Enter the solution. There is no need to make sure that they do not fall into the vessel.
#4 . Remove the needle and release the skin fold.
The skin should be gathered into a fold, which facilitates the introduction of the solution into the subcutaneous fat layer.
Treat the injection field with an antiseptic. If necessary, after administering the medicine, the puncture site can be sealed with a strip of adhesive tape.
Attention! You cannot insert a needle into the skin if there are mechanical injuries, pain, a change in color, etc. It is not recommended to inject more than 1 ml of solution at a time. Each injection must be performed within different areas bodies. The distance between them should be at least 2 cm.
- a method of administering drugs, in which the drug enters the body by introducing an injection solution through a syringe into the body subcutaneous tissue. When conducting subcutaneous injection The drug enters the bloodstream by absorption of the drug into the vessels of the subcutaneous tissue. Typically, most drugs in the form of solutions are well absorbed in the subcutaneous tissue and provide relatively rapid (within 15-20 minutes) absorption into the subcutaneous tissue. big circle blood circulation Typically, the effect of the drug when administered subcutaneously begins more slowly than when administered intramuscularly or intravenous administration, but faster than oral administration. Most often, drugs are administered subcutaneously that do not have a local irritant effect and are well absorbed in the subcutaneous fatty tissue. Heparin and its derivatives are administered exclusively subcutaneously or intravenously (due to the formation of hematomas at the injection site). Subcutaneous injection is used when it is necessary to introduce into the muscle both an aqueous and an oily solution of drugs, or a suspension, in a volume of no more than 10 ml (preferably no more than 5 ml). Subcutaneous vaccinations against infectious diseases by introducing a vaccine into the body.
Application
Subcutaneous injection is a fairly common type parenteral administration medications due to good vascularization of subcutaneous tissue, promotes rapid absorption of medications; and also due to the simplicity of the administration technique, which allows this method of administration to be used by persons without special medical training after mastering the relevant skills. Most often, patients independently administer subcutaneous insulin injections at home (often using a syringe pen); subcutaneous injections of growth hormone can also be performed. Subcutaneous administration can also be used to administer oil solutions or suspensions of medicinal substances (subject to the condition that the oil solution does not enter the bloodstream). Usually, drugs are administered subcutaneously when there is no need to obtain an immediate effect from the drug administration (absorption of the drug during subcutaneous injection occurs within 20-30 minutes after administration), or when it is necessary to create a kind of drug depot in the subcutaneous tissue to maintain the concentration of the drug in the blood at constant level long time. Solutions of heparin and its derivatives are also administered subcutaneously due to the formation of hematomas at the injection site during intramuscular injections. Drugs may also be administered subcutaneously to local anesthesia. When administered subcutaneously, it is recommended to administer drugs in a volume of no more than 5 ml to avoid tissue overstretching and the formation of infiltrate. Do not administer subcutaneously drugs that have local irritant effect and can cause necrosis and abscesses at the injection site. To carry out the injection, you must have sterile medical equipment - a syringe, and a sterile form of the drug. Intramuscular drugs can be administered both in a medical institution (inpatient and outpatient departments) and at home, by inviting medical worker home, and in case of emergency medical care- and in the ambulance.
Execution technique
Subcutaneous injection is most often performed in the outer surface of the shoulder, the anterior surface of the thigh, the subscapular area, the lateral surface of the anterior abdominal wall and the area around the navel. Before a subcutaneous injection, the drug (especially in the form of an oil solution) must be heated to a temperature of 30-37 ° C. Before starting the injection, the medical worker treats his hands with a disinfectant solution and puts on rubber gloves. Before administering the drug, the injection site is treated antiseptic solution(most often - ethyl alcohol). Before the injection, the skin at the puncture site is folded, and after that the needle is installed at an acute angle to the skin surface (for adults - up to 90 °, for children and people with a weak subcutaneous fat layer, insertion at an angle of 45 °). After puncturing the skin, the syringe needle is inserted into the subcutaneous tissue approximately 2/3 of the length (at least 1-2 cm); to prevent needle breakage, it is recommended to leave at least 0.5 cm of the needle above the skin surface. After puncturing the skin, before injecting the drug, it is necessary to pull the syringe plunger back to check that the needle has entered the vessel. After checking that the needle is located correctly, the drug is injected under the skin in full. After completing the administration of the drug, the injection site is re-treated with an antiseptic.
Advantages and disadvantages of subcutaneous use of drugs
The advantages of subcutaneous administration of drugs are that active ingredients when introduced into the body, they do not change at the site of contact with tissues, so drugs that are destroyed by enzymes can be used subcutaneously digestive system. In most cases, subcutaneous administration provides a rapid onset of action of the drug. If prolonged action is necessary, drugs are usually administered subcutaneously in the form of oil solutions or suspensions; they cannot be administered intravenously. Some medications (in particular, heparin and its derivatives) cannot be administered intramuscularly, but only intravenously or subcutaneously. The rate of absorption of the drug is not affected by food intake and is much less influenced by the characteristics of the biochemical reactions of the body of a particular person, the use of other drugs, and the state of the enzymatic activity of the body. Subcutaneous injection is relatively simple to perform, which makes it possible for even a non-specialist to carry out this manipulation if necessary.
The disadvantages of subcutaneous use are that often when drugs are administered intramuscularly, pain and the formation of infiltrates at the injection site are observed (less often, the formation of abscesses), and when insulin is administered, lipodystrophy can also be observed. With poor development blood vessels at the injection site, the rate of absorption of the drug may decrease. With subcutaneous administration of drugs, as with other types of parenteral use of drugs, there is a risk of infection of the patient or health care worker with pathogens of infectious diseases transmitted through the blood. Subcutaneous administration increases the likelihood side effect drugs due to the higher speed of entry into the body and the absence of biological filters of the body - the mucous membrane - along the route of the drug gastrointestinal tract and hepatocytes (although lower than with intravenous and intramuscular use) .. For subcutaneous use, it is not recommended to administer more than 5 ml of solution at a time due to the likelihood of overstretching muscle tissue and reducing the likelihood of infiltration formation, as well as drugs that have a locally irritating effect and can cause necrosis and abscesses at the injection site.
Possible complications of subcutaneous injection
Most a common complication subcutaneous injection is the formation of infiltrates at the injection site. Typically, infiltrates are formed when the drug is injected into a site of compaction or swelling formed after previous subcutaneous injections. Infiltrates can also form when introducing oil solutions that are not heated to the optimal temperature, as well as when the maximum volume of subcutaneous injection is exceeded (no more than 5 ml at a time). When infiltrates appear, it is recommended to apply a rolling semi-alcohol compress or heparin ointment to the site of infiltration formation and apply to the affected area iodine grid, carry out physiotherapeutic procedures.
One of the complications that arise when the technique of drug administration is violated is the formation of abscesses and phlegmons. These complications most often arise against the background of improperly treated post-injection infiltrates, or when the rules of asepsis and antisepsis are violated during injection. Treatment of such abscesses or phlegmons is carried out by a surgeon. If the rules of asepsis and antisepsis are violated when performing injections, there is a risk of infection of patients or healthcare workers with pathogens of infectious diseases transmitted through the blood, as well as the occurrence of a septic reaction due to bacterial infection of the blood.
When injecting with a blunt or deformed needle, subcutaneous hemorrhages are likely to occur. If bleeding occurs during a subcutaneous injection, it is recommended to apply a cotton swab moistened with alcohol to the injection site, and later a semi-alcohol compress.
If the injection site is chosen incorrectly when administering drugs subcutaneously, damage to the nerve trunks may occur, which is most often observed as a result of chemical damage to the nerve trunk, when a drug depot is created close to the nerve. This complication can lead to the formation of paresis and paralysis. Treatment of this complication is carried out by a doctor depending on the symptoms and severity of the lesion.
When insulin is administered subcutaneously (more often with long-term administration of the drug in the same place), there may be an area of lipodystrophy (the area of resorption of subcutaneous fat tissue). Prevention of this complication is alternating insulin injection sites and administering insulin, which has room temperature, treatment consists of administering 4-8 units of insulin to areas of lipodystrophy.
In case of mistaken injection under the skin hypertonic solution(10% sodium chloride or calcium chloride solution) or other topical irritants, tissue necrosis may occur. If this complication occurs, it is recommended to inject the affected area with a solution of adrenaline, 0.9% sodium chloride solution and novocaine solution. After pricking the injection site, a compressive dry bandage and cold are applied, and later (after 2-3 days) a heating pad is applied.
If you use an injection needle with a defect, if the needle is inserted too deeply into the subcutaneous tissue, or if the technique of administering the drug is violated, the needle may break. At this complication you must try to independently obtain a fragment of the needle from the tissue, and if the attempt is unsuccessful, the fragment is removed surgically.
Very severe complication subcutaneous injection is a drug embolism. This complication occurs rarely, and is associated with a violation of the injection technique, and occurs in cases where a health care worker, when performing a subcutaneous injection of an oil solution of a drug or suspension, does not check the position of the needle and the possibility of this drug getting into the vessel. This complication can manifest itself as attacks of shortness of breath, the appearance of cyanosis, and often ends in the death of patients. Treatment in such cases is symptomatic.
From a medical point of view, an injection means the introduction of a drug into the body using a syringe with a needle. As a rule, injections are used for precise dosing of medication, it increased concentration in a certain place or to accelerate the effect of medications. Let's look at how intradermal and subcutaneous injection is done.
Types of injections
Doctors distinguish several types of injections: subcutaneous, intramuscular, arterial, venous and injections directly into organs. They all have their own characteristics and administration techniques. So, let's look at the first two types.
What is a subcutaneous injection?
Injections under the skin are used to safely administer the drug precisely to those areas of the body where there are no large vessels and nerves (brachial, subscapular, interscapular areas, inner surface thighs, as well as the stomach.) For this method, both watery and oily solutions are used. For watery ones, thinner needles are used, for oily ones, thicker ones, which makes it easier for the drug to enter the tissue. To ensure that the subcutaneous oil injection does not require significant force, it is recommended to first warm the ampoule with the medicine in warm water, and introduce the solution itself more slowly. Such injections can be given with the patient lying down, sitting or standing. So, let's look at how to do subcutaneous injections.
Subcutaneous injection: technique
Doctors distinguish between two methods of administering medication subcutaneously:
1. The syringe is taken into right hand in such a way that the little finger holds the needle cannula, then you need to make a small fold of skin and introduce the medicine. The peculiarity of this method is that the needle is inserted perpendicular to the injection site.
2. The same position of the syringe in the hand involves inserting the needle from bottom to top or top to bottom at an angle of 30-45 degrees (often used for subscapular or interscapular areas).
It is worth emphasizing that the future injection site must first be treated with a sterile, preferably alcohol solution, and after administering the medicine, this procedure should be repeated. It is also worth paying attention: if some time after the injection a lump forms in its place, you can no longer inject medications into this area.
What is an intradermal injection?
Intradermal injections, in turn, are used to identify a patient’s allergy to a drug. They are often a biological sample (for example, a Mantoux test) or are used to local anesthesia small area. Injections of this type are made into the upper and middle parts of the forearm if the patient is not sick at the time of injection. respiratory diseases, and he has no problems with the skin at the site of the biological test.
Technique for performing intradermal injection:
- treat the surface of your hands, put on sterile gloves;
- prepare an ampoule with medicine;
- draw the medicine into the syringe;
- change the needle, eliminate the presence of air in the syringe;
- treat the future injection site with an alcohol solution;
- slightly stretch the skin at the test site;
- insert a needle under the skin parallel to the middle or upper part of the forearm;
- introduce the solution. When administered correctly, a subcutaneous bubble is formed, which must be treated with alcohol without pressing on it. If the technique is followed, both intradermal and subcutaneous injection will not lead to severe consequences, on the contrary, they will help in diagnosis or become the most important weapon in treating the disease.
In everyday life, the ability to perform subcutaneous injections is not as important as the ability to intramuscular injections, but the nurse must have the skills to carry out this procedure (know the algorithm for performing a subcutaneous injection).
Subcutaneous injection is performed on depth 15 mm. Maximum effect from a subcutaneously administered drug is achieved on average 30 minutes after injection.
The most convenient areas for subcutaneous administration of drugs:
- upper third of the outer surface of the shoulder,
- subscapular space,
- anterolateral surface of the thigh,
- lateral surface of the abdominal wall.
Do not inject medications into areas with swollen subcutaneous fat or into lumps from poorly absorbed previous injections.
Required equipment:
- sterile syringe tray,
- disposable syringe,
- ampoule with drug solution,
- 70% alcohol solution,
- pack with sterile material (cotton balls, swabs),
- sterile tweezers,
- tray for used syringes,
- sterile mask,
- gloves,
- anti-shock kit,
- container with disinfectant solution.
Procedure to complete:
The patient should take a comfortable position and free the injection site from clothing (if necessary, help the patient with this).Wash your hands thoroughly with soap and warm running water; Without wiping with a towel, so as not to disturb the relative sterility, wipe your hands well with alcohol; put on sterile gloves and also treat them with a sterile cotton ball soaked in a 70% alcohol solution.
Prepare a syringe with medicine (see article).
Treat the injection site with two sterile cotton balls soaked in a 70% alcohol solution, widely, in one direction: first a large area, then with the second ball directly at the injection site.
Remove any remaining air bubbles from the syringe, take the syringe in your right hand, index finger holding the needle sleeve, and holding the cylinder with your thumb and fingers.
Form a fold of skin at the injection site by grasping the skin with the thumb and index finger of your left hand so as to form a triangle.
Insert the needle with a quick movement at an angle of 30-45°, cut upward, into the base of the fold to a depth of 15 mm; At the same time, you need to hold the needle sleeve with your index finger.
Release the fold; make sure that the needle does not fall into the vessel by slightly pulling the piston towards you (there should be no blood in the syringe); If there is blood in the syringe, the needle should be inserted again.
Left hand transfer to the piston and, pressing on it, slowly insert medicinal substance.
Press the injection site with a sterile cotton ball soaked in a 70% alcohol solution and quickly remove the needle.
Place the used syringe and needles in the tray; Place used cotton balls in a container with a disinfectant solution.
Remove gloves, wash hands.
After the injection, the formation of a subcutaneous infiltrate is possible, which most often appears after the introduction of unheated oil solutions, as well as in cases where the rules of asepsis and antisepsis are not followed.
Intramuscular injections
Intramuscular injections are most often carried out in the upper outer quadrant of the gluteal region (to determine the injection site, the buttock area is conventionally divided into four squares by two lines (Fig. 9, Appendix)) or the anterior outer surface of the thigh.
Patient position- lying on your stomach or side (this position helps relax the muscles of the gluteal region).
Execution order:
preparing a syringe with medication for injection:
Open the packaging of the disposable syringe, take the needle by the sleeve with tweezers in your right hand, and place it on the syringe;
Check the patency of the needle by passing air or a sterile solution through it, holding the sleeve with your index finger, place the prepared syringe in a sterile tray;
Before opening an ampoule or bottle, carefully read the name of the medicine to make sure it corresponds to the doctor’s prescription, check the dosage and expiration date;
Lightly tap the neck of the ampoule with your finger so that the entire solution ends up in the wide part of the ampoule;
File the ampoule in the area of its neck with a nail file and treat it with a cotton ball soaked in a 70% alcohol solution; when taking the solution from the bottle, remove the aluminum cap from it with non-sterile tweezers and wipe the rubber stopper with a sterile cotton ball moistened with a 70% alcohol solution;
Using the cotton ball used to wipe the ampoule, break off the upper (narrow) end of the ampoule;
Take the ampoule in your left hand, holding it with your thumb, index and middle fingers, and take the syringe in your right hand;
Carefully insert a needle placed on a syringe into the ampoule and, pulling back the piston, gradually draw the required amount of the contents of the ampoule into the syringe, tilting it if necessary;
When drawing a solution from a bottle, pierce the rubber stopper with a needle, put the needle with the bottle on the cone of the syringe, lift the bottle upside down and draw the required amount of the medicinal substance into the syringe;
Remove the syringe from the needle to collect the drug and put the injection needle on it;
Remove any air bubbles in the syringe; to do this, turn the syringe with the needle up and, holding it vertically at eye level, press the piston to release air and the first drop of the drug, holding the needle by the sleeve with the index finger of your left hand;
Perpendicular to the surface of the skin, with a vigorous movement at an angle of 90º, insert the needle to a depth of 3/4 of its length (the needle must be inserted so that 2-3 mm remains between the needle sleeve and the patient’s skin);
Then, slowly pressing on the syringe plunger, inject the medicinal substance evenly;
The needle should be removed from the patient’s body with a sharp movement, at the same angle, without making unnecessary movements of the needle in the tissues;
Treat the injection site with a clean cotton swab soaked in 70% ethyl alcohol.
Subcutaneous injections
Due to the fact that the subcutaneous fat layer is well supplied with blood vessels, subcutaneous injections are used for faster action of the drug. Subcutaneously administered medicinal substances have an effect faster than when administered orally, because they are quickly absorbed. Subcutaneous injections are made with a needle of the smallest diameter to a depth of 15 mm and up to 2 ml of medications are injected, which are quickly absorbed into the loose subcutaneous tissue and do not have a harmful effect on it.
The most convenient sites for subcutaneous injection are:
Outer surface of the shoulder;
Subscapular space;
Anterior outer surface of the thigh;
Lateral surface of the abdominal wall;
The lower part of the axillary region.
In these places, the skin is easily caught in the fold and there is no danger of damage to blood vessels, nerves and periosteum.
In places with edematous subcutaneous fat;
In seals from poorly absorbed previous injections.
Execution order:
Wash your hands thoroughly with soap and running warm water; without wiping with a towel, so as not to disturb the relative sterility, wipe them with alcohol; wear sterile gloves;
Preparing a syringe with medication (see IM injection);
Treat the injection site sequentially with two cotton balls with alcohol: first a large area, then the injection site itself;
Place the third ball of alcohol under the 5th finger of your left hand;
Take the syringe in your right hand (hold the needle cannula with the 2nd finger of your right hand, hold the syringe piston with the 5th finger, hold the cylinder from the bottom with the 3rd-4th fingers, and the top with the 1st finger);
With your left hand, gather the skin into a triangular fold, base down;
Insert the needle at an angle of 45° into the base of the skin fold to a depth of 1-2 cm (2/3 of the needle length), hold the needle cannula with your index finger;
Place your left hand on the plunger and inject the medicine (without transferring the syringe from one hand to the other).
Remove the needle, holding it by the cannula;
Press the injection site with a cotton ball and alcohol;
Give a light massage to the injection site without removing the cotton wool from the skin.
Intravenous injections
To perform intravenous injections, it is necessary to prepare on a sterile tray: a syringe (10.0 - 20.0 ml) with a drug and a 40 - 60 mm needle, cotton balls; tourniquet, roller, gloves; 70% ethyl alcohol; tray for used ampoules, vials; container with a disinfectant solution for used cotton balls.
Execution order:
Wash your hands thoroughly with soap and running warm water; without wiping with a towel, so as not to disturb the relative sterility, wipe them with alcohol; wear sterile gloves;
Draw the medicine from the ampoule into a disposable syringe;
Help the patient take a comfortable position - lying on his back or sitting;
Give the limb into which the injection will be made the required position: the arm is extended, palm up;
Place an oilcloth pad under your elbow (for maximum extension of the limb in elbow joint);
Place a rubber band (on a shirt or napkin) on the middle third of the shoulder so that its free ends are directed up, the loop is down, the pulse is at radial artery however, it should not change;
Ask the patient to work with his fist (to better pump blood into the vein);
Find a suitable vein for puncture;
Treat the skin in the area of the elbow bend with the first cotton ball soaked in 70% ethyl alcohol, in the direction from the periphery to the center, discard it (pre-treatment of the skin);
Take the syringe in your right hand: fix the needle cannula with your index finger, and use the rest to cover the cylinder from above;
Check that there is no air in the syringe; if there are a lot of bubbles in the syringe, you need to shake it, and the small bubbles will merge into one large one, which can be easily pushed out through the needle into the tray;
Again, with your left hand, treat the venipuncture site with a second cotton ball with alcohol, discard it;
Fix the skin in the puncture area with your left hand, stretching the skin in the area of the elbow with your left hand and slightly shifting it to the periphery;
Holding the needle with the bevel upward at an angle of 45°, insert it under the skin, then reducing the angle of inclination and holding the needle almost parallel to the surface of the skin, move it along the vein and carefully insert the needle 1/3 of its length (with the patient’s clenched fist);
Continuing to fix the vein with your left hand, slightly change the direction of the needle and carefully puncture the vein until you feel “entering the void”;
Pull the plunger towards you - blood should appear in the syringe (confirmation that the needle has entered a vein);
Untie the tourniquet with your left hand, pulling one of the free ends, ask the patient to unclench his hand;
Without changing the position of the syringe, press the plunger with your left hand and slowly inject the medicinal solution, leaving 0.5 ml in the syringe (if it was not possible to completely remove air from the syringe);
Apply a cotton ball with alcohol to the injection site and carefully remove the needle from the vein (hematoma prevention);
Bend the patient’s arm at the elbow joint, leave the ball of alcohol in place, ask the patient to fix the arm in this position for 5 minutes (to prevent bleeding);
Dump the syringe into disinfectant solution or cover the needle with a cap;
After 5-7 minutes, take the cotton ball from the patient and throw it into a disinfectant solution or into a bag from a disposable syringe;
Remove gloves and place them in a disinfectant solution;
Wash the hands.
Preparing the intravenous transfusion system
(Fig. 10, appendix)
1. Put on a mask, wash your hands thoroughly with soap and running warm water, without wiping with a towel, so as not to disturb the relative sterility, wipe them with 70% ethyl alcohol, put on sterile gloves.
2. Check the expiration date and tightness of the packaging with the system by squeezing it on both sides.
3. Prepare a sterile tray with napkins and cotton balls.
4. Take a bottle with a medicinal substance, check the expiration date, appearance, check with medical prescriptions.
5. Remove the central part of the metal cap from the bottle with tweezers and treat the bottle stopper twice with cotton balls soaked in 70% ethyl alcohol.
6. Open the package and remove the system.
7. Close the clamp on the system.
8. Remove the cap from the polymer needle and insert it into the bottle until it stops.
9. Turn the bottle upside down and secure it on a tripod.
10.Open the air duct plug on the system.
11.Fill the dropper to half the control container, periodically pressing on its body.
12.Open the clamp and release air from the tube system.
13.Close the clamp and fix the system on the tripod.
14. Perform venipuncture.
15.Use the clamp to adjust the required infusion rate.
16. After the manipulation, the used system must be disinfected (before soaking the system in the solution, it must be cut with scissors).
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