Parenteral Medications Management Notes

Parenteral Medications Overview

  • Definition: Medications administered through a route other than the alimentary tract (e.g., intravenous, intramuscular).
  • Routes of Administration:
    • Subcutaneous
    • Intramuscular
    • Intradermal
    • Intravenous
  • Characteristics:
    • Absorbed more quickly than oral medications.
    • Requires careful and accurate administration.
    • Requires aseptic technique to prevent infections.

Equipment for Parenteral Medications

  • Syringe Components:
    • Tip: Connects with the needle.
    • Barrel: Holds the liquid medication.
    • Plunger: Fits inside the barrel; dosage is read at the flange of the plunger tip.
    • Types of Syringes:
    • Hypodermic: Sizes ranging from 2 to 5ml.
    • Insulin: Calibrated scale in units.
    • Tuberculin: Uses ml and minim scale.

Needle Specifications

  • Needle Parts:

    • Bevel: Slanted tip for easier entry.
    • Shaft: Main body of the needle.
    • Hub: Connects the needle to the syringe.

  • Needle Sizes:

    • As gauge increases (e.g., 16, 18, 20, 23, 25), the diameter decreases.

Syringe Types

  • Luer-Lok: Syringe with a threaded tip for secure needle attachment.
  • Non-Luer-Lok: Smooth graduated tip without threading.

Prefilled Syringes

  • Prepared with a cartridge that locks into the syringe barrel.
  • Plunger screws into the cartridge for medication dispensing.

Preparation of Medications

  • From Ampules:

    • Break the neck of the ampule before drawing medication.
    • Use a filter needle for withdrawal to avoid glass particles.

  • From Vials:

    • Air must be injected into a vial before withdrawing medication.
    • Scrub the vial's rubber top with an antiseptic before use.

Injection Techniques

  • Site Preparation:
    • Clean the injection site with antiseptic swabs for 15 seconds, moving from center to outward in a circular motion.
  • Injection Angles:
    • Intradermal: 10-15 degrees.
    • Subcutaneous: 45 degrees.
    • Intramuscular: 90 degrees.

Intramuscular Injection Sites

  • Preferred Sites:

    • Ventrogluteal: Safe for larger volumes (up to 3ml).
    • Vastus Lateralis: Common for adults and infants.
    • Deltoid: Easily accessible; smaller volume.

  • Non-preferred Sites:

    • Rectus Femoris: Often not recommended due to risk of injury.
    • Dorsogluteal: Risk of sciatic nerve injury.

Safety Procedures

  • Prevention of Needle Sticks:
    • Use scoop method to avoid needle stick injuries.
    • Engage the safety device immediately after injection.
    • Never recap a contaminated needle.
  • Disposal:
    • Place used needles in a sharps container, ensuring horizontal placement to avoid puncture.

Documentation and Evaluation

  • Always document the medication administration including:
    • Patient's name, MRN, medication name, dosage, and administration time.
  • Evaluate medication effectiveness and document any adverse effects or relief of symptoms in the patient's record.