Administration of medication by subcutaneous route

Preparation and administration of prescribed medications subcutaneously and evaluation of patient response.

Objective:

– To administer prescribed medication to the patient subcutaneously for therapeutic purposes.

Equipment:

– Trough. – Sharps container.

Material:

– Prescribed medication. – Disposable gloves. – Subcutaneous needle. – 1 Syringe of 1 or 2 ml. – Cotton swab. – Antiseptic. – Marker pen. – Nursing records.

Procedure:

– Perform hand washing. – Follow general rules in the administration of medication. – Prepare the medication (correctly prepare the dose from an ampoule or vial). – Determine the patient’s knowledge of the medication and understanding of the method of administration.

– Choose the puncture site. – Position the patient in a comfortable position according to the chosen injection site. – Assess the puncture site for bruises, edema, lesions, abrasions or infections. – Clean the area with cotton impregnated with antiseptic. Perform circular movements in an area of 5 cm from inside to outside. – Allow the antiseptic to dry. – Form a skin fold with the index finger and thumb of the non-dominant hand, if a 90º angle is used. – Hold syringe with dominant hand and insert the needle with the bevel upwards at an angle of 45-90º. – Aspirate to check that it has not connected with a blood vessel and inject slowly (if blood refluxes when aspirating, remove the needle and discard syringe and medication. Repeat the procedure) – It is recommended not to aspirate when administering heparin and insulin. – Remove the needle and release the skin fold, apply gentle pressure on the puncture site (without rubbing).

Administration of Heparin Calcium:

a) Select puncture site ( arm, abdomen and leg) if in the patient’s abdomen, above the level of the anterior iliac spine. b) Pinch a fold of 1.5 cm and introduce the needle perpendicularly, do not release the pinch until the needle is extracted. c) Do not aspirate or apply massage after injection, as this may cause hematoma. d) In pre-filled syringes do not eliminate the air bubble. Introduce all the air that is in the syringe to ensure the total administration of the dose. e) Subcutaneous heparin can produce local bleeding when injected in arms and legs. f) Record the puncture site to rotate for the next dose. – Discard the needle and syringe in the container according to waste segregation criteria. – Collect the material. – Remove gloves. – Leave the patient in a comfortable position. – Wash hands. – Record: medication administered, dose, route, date and time, incidents and patient response.

Observations:

– Alternate puncture sites to avoid atrophy of the subcutaneous tissue and abscesses. The most frequent areas are: abdomen, outer arms, outer thighs and buttocks. – When two preparations are used in the administration of insulin, the rapid insulin should be loaded first. The mixture should be administered within 5 minutes since the slow insulin decreases the action of the rapid insulin.