In the form of injections, injections for me. Technology for performing subcutaneous injection: placement sites. Goals and intended learning outcomes

Execution technique subcutaneous injection:
Purpose: therapeutic, preventive
Indications: determined by the doctor
Subcutaneous injection is deeper than intradermal and is performed to a depth of 15 mm.

Rice. Subcutaneous injection: needle position.

Subcutaneous tissue has a good blood supply, so medications are absorbed and act faster. Maximum effect subcutaneously administered medication usually wears off within 30 minutes.

Injection sites for subcutaneous injection: upper third of the outer surface of the shoulder, back (subscapular region), anterolateral surface of the thigh, lateral surface abdominal wall.

Prepare equipment:
- soap, personal towel, gloves, mask, skin antiseptic (for example: Lizanin, AHD-200 Special)
- an ampoule with a medicinal product, a nail file for opening the ampoule
- sterile tray, waste material tray
- disposable syringe with a volume of 2 - 5 ml, (a needle with a diameter of 0.5 mm and a length of 16 mm is recommended)
- cotton balls in 70% alcohol
- first aid kit “Anti-HIV”, as well as containers with disinfectant. solutions (3% chloramine solution, 5% chloramine solution), rags

Preparation for manipulation:
1. Explain to the patient the purpose and course of the upcoming manipulation, obtain the patient’s consent to perform the manipulation.
2. Treat your hands at a hygienic level.
3.Help the patient into the desired position.

Algorithm for performing subcutaneous injection:
1. Check the expiration date and tightness of the syringe packaging. Open the package, assemble the syringe and place it in a sterile patch.
2. Check the expiration date, name, physical properties and dosage medicinal product. Check with the assignment sheet.
3. Take 2 cotton balls with alcohol with sterile tweezers, process and open the ampoule.
4. Fill the syringe with the required amount of the drug, release the air and place the syringe in a sterile patch.
5. Use sterile tweezers to place 3 cotton balls.
6. Put on gloves and treat the ball with 70% alcohol, throw the balls into a waste tray.
7. Treat a large area with the first ball in alcohol centrifugally (or in the direction from bottom to top) skin, apply the second ball directly to the puncture site, wait until the skin dries from the alcohol.
8. Throw the balls into the waste tray.
9. With your left hand, grasp the skin at the injection site in the warehouse.
10. Place the needle under the skin at the base of the skin fold at an angle of 45 degrees to the surface of the skin with a cut to a depth of 15 mm or 2/3 of the length of the needle (depending on the length of the needle, the indicator may vary); index finger; Hold the needle cannula with your index finger.
11. Move the hand fixing the fold to the piston and inject the medicine slowly, try not to transfer the syringe from hand to hand.
12. Remove the needle, continuing to hold it by the cannula; hold the puncture site with a sterile cotton swab moistened with alcohol. Place the needle in a special container; if a disposable syringe is used, break the needle and cannula of the syringe; take off your gloves.
13. Make sure that the patient feels comfortable, take the 3rd ball from him and escort the patient.

Rules for introducing oil solutions. Oil solutions are often administered subcutaneously; intravenous administration is prohibited.

Drops of the oil solution entering the vessel are clogged with it. The nutrition of surrounding tissues is disrupted, and their necrosis develops. With the blood flow, oil emboli can enter the vessels of the lungs and cause their blockage, which is accompanied by severe suffocation and can cause the death of the patient. Oil solutions are poorly absorbed, so an infiltrate may develop at the injection site. Before administration, warm oil solutions to a temperature of 38 "C; before administering the medicine, pull the plunger towards you and make sure that blood does not enter the syringe, i.e. you do not get into blood vessel. Only then slowly introduce the solution. Apply a heating pad or a warm compress to the injection site: this will help prevent infiltration.

Currently, there are three main methods of parenteral (i.e. bypassing digestive tract) administration of drugs: subcutaneously, intramuscularly and intravenously. The main advantages of these methods include speed of action and dosage accuracy. It is also important that the medicine enters the blood unchanged, without being subject to degradation by enzymes of the stomach and intestines, as well as the liver. Administration of drugs by injection is not always possible due to certain mental illness accompanied by fear of injection and pain, as well as bleeding, skin changes at the site of the intended injection (for example, burns, purulent process), hypersensitivity skin, obesity or exhaustion. In order to avoid complications after an injection, you need to choose the right needle length. For injections into a vein, needles 4-5 cm long are used, for subcutaneous injections - 3-4 cm, and for intramuscular injections - 7-10 cm. Needles for intravenous infusions should have a cut at an angle of 45°, and for subcutaneous injections the cut angle should be sharper. It should be remembered that all instruments and injection solutions must be sterile. For injections and intravenous infusions, only disposable syringes, needles, catheters and infusion systems should be used. Before performing the injection, you must read the doctor's prescription again; carefully check the name of the medicine on the packaging and on the ampoule or bottle; check the expiration dates of medicines and disposable medical instruments.

Currently used syringe for single use, Available assembled. Such plastic syringes are factory sterilized and packaged in separate bags. Each package contains a syringe with a needle attached to it or with a needle located in a separate plastic container.

Procedure to complete:

1. Open the package of the disposable syringe, use tweezers in your right hand to take the needle by the coupling, and place it on the syringe.

2. 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.

3. 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.

4. Lightly tap the neck of the ampoule with your finger so that the entire solution ends up in the wide part of the ampoule.

5. 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 and alcohol.

6. Using the cotton ball used to wipe the ampoule, break off the upper (narrow) end of the ampoule. To open the ampoule, you must use a cotton ball to avoid injury from glass fragments.

7. Take the ampoule in your left hand, holding it with your thumb, index and middle fingers, and right hand- syringe.

8. Carefully insert a needle placed on a syringe into the ampoule and, pulling back, gradually draw the required amount of the contents of the ampoule into the syringe, tilting it as necessary;

9. When drawing a solution from a bottle, pierce the rubber stopper with a needle, put the needle with the bottle on the needle cone of the syringe, lift the bottle upside down and draw the required amount of content into the syringe, disconnect the bottle, and change the needle before injection.

10.Remove air bubbles in the syringe: turn the syringe with the needle up and, holding it vertically at eye level, press the piston to release the air and the first drop medicinal substance.

Intradermal injection

1. Draw the prescribed amount into the syringe medicinal solution.

2. Ask the patient to take a comfortable position (sit or lie down) and remove clothing from the injection site.

3. Treat the injection site with a sterile cotton ball soaked in a 70% alcohol solution, making movements in one direction from top to bottom; wait until the skin at the injection site dries.

4. With your left hand, grab the patient’s forearm from the outside and fix the skin (do not pull it!).

5. With your right hand, guide the needle into the skin with a cut upward in the direction from bottom to top at an angle of 15 o to the skin surface for the length of only the cut of the needle so that the cut is visible through the skin.

6. Without removing the needle, slightly lifting the skin with the cut of the needle (forming a “tent”), move your left hand to the syringe plunger and, pressing on the plunger, inject the medicinal substance.

7. Remove the needle with a quick movement.

8. Place the used syringe and needles in the tray; Place used cotton balls in a container with disinfectant solution.

Subcutaneous injections

Due to the fact that the subcutaneous fat layer is well supplied with blood vessels, for more fast acting The drug is administered by subcutaneous injection. Drugs administered subcutaneously have an effect faster than when administered orally. 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 administered, which are quickly absorbed from the loose subcutaneous tissue and do not affect it. harmful effects. The most convenient areas for subcutaneous administration are: the outer surface of the shoulder; subscapular space; anterior outer surface of the thigh; lateral surface of the abdominal wall; 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. It is not recommended to inject into areas with swollen subcutaneous fat, or into lumps from poorly resolved previous injections.

Technique:

Wash your hands (wear gloves);

· 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 hold the top with the 1st finger);

· gather the skin into a fold with your left hand triangular shape, 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 medication (do not transfer the syringe from one hand to the other).

Attention!If there is a small air bubble in the syringe, inject the medicine slowly and do not release the entire solution under the skin, leave a small amount along with the air bubble in the syringe:

· remove the needle, holding it by the cannula;

· Press the injection site with a cotton ball and alcohol;

· do light massage injection sites without removing the cotton wool from the skin;

· put a cap on the disposable needle and throw the syringe into the trash container.

Intramuscular injections

Some drugs, when administered subcutaneously, cause pain and are poorly absorbed, which leads to the formation of infiltrates. When using such drugs, as well as in cases where a faster effect is desired, subcutaneous administration is replaced by intramuscular administration. Muscles have a wide network of blood vessels and lymphatic vessels, which creates conditions for rapid and complete absorption of drugs. With intramuscular injection, a depot is created from which the drug is slowly absorbed into the bloodstream, and this maintains its required concentration in the body, which is especially important in relation to antibiotics. Intramuscular injections should be made in certain places of the body, where there is a significant layer of muscle tissue and large vessels and nerve trunks do not come close. The length of the needle depends on the thickness of the subcutaneous fat layer, since it is necessary that the needle passes through subcutaneous tissue and got into the thickness of the muscles. So, with an excessive subcutaneous fat layer, the needle length is 60 mm, with a moderate one - 40 mm. The most suitable places for intramuscular injections are the muscles of the buttocks, shoulder, thigh.

For intramuscular injections into the gluteal region Only the upper outer part is used. It should be remembered that accidental needle contact with sciatic nerve may cause partial or complete paralysis of a limb. In addition, there is a bone (sacrum) and large vessels nearby. In patients with flabby muscles, this place is difficult to localize.

Place the patient either on their stomach (toes turned inward) or on their side (the leg that is on top is bent at the hip and knee to relax

gluteal muscle). Feel the following anatomy: superior posterior iliac spine and large skewer femur. Draw one line perpendicularly down from the middle

spine to the middle of the popliteal fossa, the other - from the trochanter to the spine (the projection of the sciatic nerve runs slightly below the horizontal line along the perpendicular). Locate the injection site, which is located in the superior outer quadrant, approximately 5-8 cm below the iliac crest. For repeated injections, it is necessary to alternate between the right and left side, change injection sites: this reduces the pain of the procedure and prevents complications.

Intramuscular injection into the vastus lateralis muscle carried out in the middle third. Position right hand 1-2 cm below the trochanter of the femur, the left one - 1-2 cm above the patella, the thumbs of both hands should be on the same line. Determine the injection site, which is located in the center of the area formed by the index and thumbs both hands. When giving injections to young children and malnourished adults, you should pinch the skin and muscle to ensure that the drug is injected into the muscle.

Intramuscular injection can be done and into the deltoid muscle. The brachial artery, veins and nerves run along the shoulder, so this area is used only when other injection sites are not available or when multiple intramuscular injections are performed daily. Free the patient's shoulder and shoulder blade from clothing. Ask the patient to relax his arm and bend it elbow joint. Feel the edge of the acromion of the scapula, which is the base of a triangle whose apex is in the center of the shoulder. Determine the injection site - in the center of the triangle, approximately 2.5-5 cm below the acromion process. The injection site can also be determined in another way by placing four fingers across the deltoid muscle, starting from the acromion process.

In order for the drug to be injected to the desired depth, the injection site, needle and angle at which the needle is inserted must be correctly selected.

Remember! All instruments and injection solutions must be sterile!

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;
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.
Injections are not recommended:

in places with edematous subcutaneous fat;
in compactions from poorly absorbed previous injections.

Performing a subcutaneous injection:

wash your hands (wear gloves);
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 hold the cylinder from 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;
move your left hand to the plunger and inject the medicine (do not transfer the syringe from one hand to the other);

Attention! If there is a small air bubble in the syringe, inject the medicine slowly and do not release the entire solution under the skin, leave a small amount along with the air bubble in the syringe.

remove the needle, holding it by the cannula;
apply pressure to the injection site with a cotton ball and alcohol;

Intramuscular injections

Intramuscular injections should be made in certain places of the body, where there is a significant layer of muscle tissue, and large vessels and nerve trunks do not come close. The length of the needle depends on the thickness of the subcutaneous fat layer, because It is necessary that when inserted, the needle passes through the subcutaneous tissue and enters the thickness of the muscles. So, with an excessive subcutaneous fat layer, the needle length is 60 mm, with a moderate one - 40 mm.

The most suitable sites for intramuscular injections are:

buttock muscles;
shoulder muscles;
thigh muscles.
Determining the injection site
For intramuscular injections into the gluteal region, only the upper outer part is used.
It should be remembered that accidentally hitting the sciatic nerve with a needle can cause partial or complete paralysis of the limb. In addition, there is a bone (sacrum) and large vessels nearby. In patients with flabby muscles, this place is difficult to localize.
- Lay the patient down, he can lie: on his stomach - toes turned inward, or on his side - the leg that is on top is bent at the hip and knee to relax the gluteal muscle.
- Palpate the following anatomical structures: the superior posterior iliac spine and the greater trochanter of the femur.
- Draw one line perpendicularly down from the middle of the spine to the middle of the popliteal fossa, the other - from the trochanter to the spine (the projection of the sciatic nerve runs slightly below the horizontal line along the perpendicular).
- Locate the injection site, which is located in the superior outer quadrant, approximately 5 to 8 cm below the iliac crest.
For repeated injections, you need to alternate between the right and left sides and change injection sites: this reduces the pain of the procedure and prevents complications.
Intramuscular injection into the vastus lateralis muscle carried out in the middle third.
- Place your right hand 1-2 cm below the trochanter of the femur, your left hand 1-2 cm above the patella, the thumbs of both hands should be on the same line.
- Locate the injection site, which is located in the center of the area formed by the index fingers and thumbs of both hands.
When giving injections to young children and malnourished adults, you should pinch the skin and muscle to ensure that the drug is injected into the muscle.
An intramuscular injection can also be performed into the deltoid muscle. The brachial artery, veins and nerves run along the shoulder, so this area is used only when other injection sites are not available or when multiple intramuscular injections are performed daily.
- Free the patient's shoulder and shoulder blade from clothing.
- Ask the patient to relax his arm and bend it at the elbow joint.
- Feel the edge of the acromion process of the scapula, which is the base of the triangle, the apex of which is in the center of the shoulder.
- Determine the injection site - in the center of the triangle, approximately 2.5 - 5 cm below the acromion process. The injection site can also be determined in another way by placing four fingers across the deltoid muscle, starting from the acromion process.
Performing an intramuscular injection:
- help the patient take a comfortable position: when inserted into the buttock - on the stomach or on the side; into the thigh - lying on your back with a slightly bent knee joint kicking or sitting; in the shoulder - lying or sitting;
- determine the injection site;
- wash your hands (wear gloves); The injection is carried out as follows:
- 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 (place the 5th finger on the needle cannula, the 2nd finger on the syringe plunger, the 1st, 3rd, 4th fingers on the cylinder);
- stretch and fix the skin at the injection site with the 1-2 fingers of your left hand;
- insert the needle into the muscle at a right angle, leaving 2-3 mm of the needle above the skin;
- move your left hand to the piston, grasping the syringe barrel with the 2nd and 3rd fingers, press the piston with the 1st finger and inject the medicine;
- Press the injection site with your left hand with a cotton ball and alcohol;
- remove the needle with your right hand;
- lightly massage the injection site without removing the cotton wool from the skin;
- Place the cap on the disposable needle and throw the syringe into the trash container.
Intravenous injections
Intravenous injections involve the introduction of a medicinal substance directly into the bloodstream. The first and indispensable condition for this method of administering drugs is strict adherence to the rules of asepsis (washing and treating hands, the patient’s skin, etc.)
For intravenous injections the veins of the cubital fossa are most often used because they have large diameter, lie superficially and move relatively little, and also superficial veins hands, forearms, rarely veins lower limbs.
Saphenous veins upper limb- radial and ulnar saphenous veins. Both of these veins, connecting over the entire surface of the upper limb, form many connections, the largest of which is the middle vein of the elbow, most often used for punctures. Depending on how clearly the vein is visible under the skin and palpated (palpable), three types of veins are distinguished.
Type 1 - well contoured vein. The vein is clearly visible, clearly protrudes above the skin, and is voluminous. The side and front walls are clearly visible. During palpation, almost the entire circumference of the vein can be felt, with the exception of the inner wall.
Type 2 - weakly contoured vein. Only the anterior wall of the vessel is very clearly visible and palpated; the vein does not protrude above the skin.
Type 3 - non-contoured vein. The vein is not visible, it can only be palpated in the depths of the subcutaneous tissue by an experienced nurse, or the vein is not visible or palpated at all.
The next indicator by which veins can be divided is fixation in subcutaneous tissue(how freely the vein moves along the plane). The following options are available:
fixed vein- the vein moves along the plane slightly, it is almost impossible to move it to a distance the width of the vessel;
sliding vein- the vein easily moves in the subcutaneous tissue along the plane; it can be moved to a distance greater than its diameter; the lower wall of such a vein, as a rule, is not fixed.
Based on the severity of the wall, the following types can be distinguished:
thick-walled vein- the vein is thick, dense; thin-walled vein- a vein with a thin, easily vulnerable wall.
Using all of the listed anatomical parameters, the following clinical options are determined:
well contoured fixed thick-walled vein; such a vein occurs in 35% of cases;
well contoured sliding thick-walled vein; occurs in 14% of cases;
weakly contoured, fixed thick-walled vein; occurs in 21% of cases;
weakly contoured sliding vein; occurs in 12% of cases;
uncontoured fixed vein; occurs in 18% of cases.
The veins of the first two are most suitable for puncture clinical options. Good contours and a thick wall make it quite easy to puncture the vein.
The veins of the third and fourth options are less convenient, for the puncture of which a thin needle is most suitable. You just need to remember that when puncturing a “sliding” vein, it must be fixed with the finger of your free hand.
The veins of the fifth option are the most unfavorable for puncture. When working with such a vein, you should remember that you must first palpate (feel) it well; you cannot puncture it blindly.
One of the most common anatomical features veins is so-called fragility.
Currently, this pathology is becoming more and more common. Visually and palpably, fragile veins are no different from ordinary ones. Their puncture, as a rule, also does not cause difficulty, but sometimes a hematoma appears literally before our eyes at the puncture site. All control methods show that the needle is in the vein, but, nevertheless, the hematoma is growing. It is believed that what is probably happening is that the needle is a wounding agent, and in some cases the puncture of the vein wall corresponds to the diameter of the needle, and in others, due to anatomical features, a rupture occurs along the course of the vein.
In addition, it can be assumed that violations of the technique of fixing the needle in the vein play an important role here. A weakly fixed needle rotates both axially and in a plane, causing additional trauma to the vessel. This complication occurs almost exclusively in elderly people. If such a pathology occurs, then there is no point in continuing to administer the drug into this vein. Another vein should be punctured and infused, paying attention to fixing the needle in the vessel. A tight bandage must be applied to the area of the hematoma.
Enough a common complication there is an arrival infusion solution into the subcutaneous tissue. Most often, after puncture of a vein, the needle is not fixed firmly enough in the elbow bend; when the patient moves his hand, the needle comes out of the vein and the solution enters under the skin. The needle in the elbow bend must be fixed in at least two points, and in restless patients, the vein must be fixed throughout the limb, excluding the area of the joints.
Another reason for fluid entering under the skin is a through puncture of a vein; this often happens when using disposable needles, which are sharper than reusable ones; in this case, the solution enters partially into the vein and partially under the skin.
It is necessary to remember one more feature of veins. When central and peripheral circulation is impaired, the veins collapse. Puncture of such a vein is extremely difficult. In this case, the patient should be asked to clench and unclench his fingers more vigorously and at the same time pat the skin, looking through the vein in the puncture area. As a rule, this technique more or less helps with puncture of a collapsed vein. It must be remembered that initial training on such veins is unacceptable.
Performing an intravenous injection.
Prepare:
on a sterile tray: syringe (10.0 - 20.0 ml) with medication and needle 40 - 60 mm, cotton balls;
tourniquet, roller, gloves;
70 % ethanol;
tray for used ampoules, vials;
container with a disinfectant solution for used cotton balls.
Sequencing:
- wash and dry your hands;
- draw medicine;
- 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 the elbow (for maximum extension of the limb at the elbow joint);
- wash your hands, put on gloves;
- place a rubber band (on a shirt or napkin) on the middle third of the shoulder so that the 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 of the elbow area with the first cotton ball with alcohol in the direction from the periphery to the center, discard it (the skin is disinfected);
- 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 almost parallel to the vein, pierce the skin and carefully insert the needle 1/3 of the length with the cut up (with the patient’s fist clenched);
- 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 by 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 -1-2 ml in the syringe;
- apply a cotton ball with alcohol to the injection site and remove the needle from the vein with a gentle movement (prevention of hematoma);
- bend the patient's arm at the elbow, leave the alcohol ball in place, ask the patient to fix the arm in this position for 5 minutes (to prevent bleeding);
- dump the syringe into a disinfectant solution or cover the needle (disposable) 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;
- take off your gloves and throw them into the disinfectant solution;
- wash your hands.

In ordinary life, the ability to perform subcutaneous injections is not as important as the ability to perform 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. The 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.

In these areas, the skin is easily caught in the fold, so there is no danger of damage to blood vessels and nerves.
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 the remaining air bubbles from the syringe, take the syringe in your right hand, holding the needle sleeve with your index finger, and the cylinder with your thumb and other 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 introduce the 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.

Medicinal substances can enter the body in different ways. Most often, medications are taken orally, that is, through the mouth. There are also parenteral routes administration, which includes the injection method. With this method, the required amount of the substance very quickly enters the blood and is transferred to the “point” of application - the diseased organ. Today we will focus on the algorithm for performing an intramuscular injection, which we often call an “injection”.

Intramuscular injections are inferior to intravenous administration (infusion) in terms of the rate at which the substance enters the blood. However, many drugs are not intended for intravenous administration. It is possible to administer intramuscularly not only aqueous solutions, but also oil-based, and even suspensions. This parenteral route is the most common way to administer drugs.

If the patient is in a hospital, then there are no questions about performing intramuscular injections. But when a person is prescribed drugs intramuscularly, but he is not in the hospital, difficulties arise here. Patients may be asked to go to a clinic for procedures. However, every trip to the clinic is a health risk, which consists in the possibility of contracting infections, as well as negative emotions outraged patients in line. In addition, if a working person is not on sick leave, he simply does not have the free time during operating hours of the treatment room.

Execution Skills intramuscular injections provide significant assistance in maintaining the health of household members, and in some situations even save lives.

Advantages of intramuscular injections

fairly rapid entry of the drug into the blood (compared to subcutaneous administration);
water can be administered oil solutions and suspensions;
it is allowed to introduce substances of irritating properties;
You can administer depot drugs that give a prolonged effect.

Disadvantages of intramuscular injections

It is very difficult to give an injection yourself;
pain when administering certain substances;
administration of suspensions and oil solutions may cause pain in the injection area due to slow absorption;
some substances bind to tissues or precipitate when administered, which slows down absorption;
the risk of touching a nerve with the syringe needle, which will injure it and cause severe pain;
danger of the needle getting into a large blood vessel (especially dangerous when administering suspensions, emulsions and oil solutions: if particles of the substance enter the general bloodstream, blockage of vital vessels may occur)

Some substances are not administered intramuscularly. For example, calcium chloride will cause inflammation and tissue necrosis in the injection area.

Intramuscular injections are made in those areas where there is a fairly thick layer of muscle tissue, and the likelihood of getting into a nerve, large vessel and periosteum is low. These areas include:

gluteal region;
anterior thigh;
the posterior surface of the shoulder (much less often used for injections, since the radial and ulnar nerves, brachial artery).

Most often, when performing an intramuscular injection, they “target” the gluteal region. The buttock is mentally divided into 4 parts (quadrants) and the upper-outer quadrant is selected, as shown in the figure.

Why this particular part? Due to the minimal risk of touching the sciatic nerve and bone formations.

Choosing a syringe

The syringe must match the volume of the substance injected.
Syringes for intramuscular injections together with a needle have a size of 8-10 cm.
The volume of the medicinal solution should not exceed 10 ml.
Tip: choose syringes with a needle of at least 5 cm, this will reduce pain and reduce the risk of lumps forming after the injection.

Prepare everything you need:

Sterile syringe (before use, pay attention to the integrity of the packaging);
Ampoule/bottle with medicine (it is necessary that the medicine has body temperature, for this you can first hold it in your hand if the medicine was stored in the refrigerator; oil solutions are heated in a water bath to a temperature of 38 degrees);
Cotton swabs;
Antiseptic solution (medical antiseptic solution, boric alcohol, salicylic alcohol);
Bag for used accessories.

Injection algorithm:

Intramuscular injections can be made independently into the front surface of the thigh. To do this, you need to hold the syringe at an angle of 45 degrees, like a pen for writing. However, in this case there is a greater likelihood of hitting a nerve than in the case of gluteal insertion.

If you have never given injections yourself or even seen how it is done, you need to contact a healthcare professional. Theoretical knowledge without the help of an experienced specialist is sometimes insufficient. Sometimes it becomes psychologically difficult to insert a needle into a living person, especially a loved one. It is useful to practice injecting on surfaces whose resistance is akin to human tissue. Foam rubber is often used for this, but vegetables and fruits - tomatoes, peaches, etc. - are better suited.

Maintain sterility when performing injections and be healthy!