Preparation and delivery of prescribed medications intramuscularly and evaluation of patient response.
Objective:
– To administer prescribed medication to the patient intramuscularly for therapeutic purposes.
Equipment:
– Trough. – Sharps container.
Material:
– Prescribed medication. – Medical treatment sheet with the prescribed medication. – Disposable non-sterile gloves. – 1 Intramuscular needle of 40 x 0.8. – 1 Syringe. – Cotton swab. – Antiseptic. – 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. – Put on gloves. – Choose the injection site. – Place the patient in a comfortable position according to the chosen injection site: right or left lateral decubitus if injecting in the buttock, supine decubitus if injecting in the thigh. – Clean the area with cotton impregnated with antiseptic. Make circular movements in an area of 5 cm from inside to outside. – Let the antiseptic dry. – Insert the needle perpendicular to the skin at a 90º angle in a quick and safe movement. The technique should be performed using the so-called closed system: syringe and needle connected. – Aspirate to check that we are not connected to a blood vessel and inject slowly (if blood refluxes when aspirating, remove the needle or look for another plane). – Remove the needle avoiding lateral displacements and apply a light massage to help the distribution of the drug. – Check if the patient presents acute pain at the injection site or sensory or motor disturbances at the injection site or outside it.
If the drug to be injected is irritating or may stain the skin, the Z-technique is used:
1. perform a displacement of the subcutaneous tissue and skin overlying the muscle, prior to injection. 2. Once the drug has been injected, wait 10 seconds before removing the needle. 3. Once the needle has been withdrawn, release the displaced tissue. 4. Do not massage the puncture site. – Discard the needle and syringe in the container, according to waste segregation criteria. – Collect the material. – Leave the patient in a comfortable position. – Remove gloves. – Wash hands. – Record: medication administered, dose, route, date and time, incidents and patient response.
Observations:
The puncture sites are:
1. Gluteus maximus muscle (adults) 0.1 to 5 ml. 2. Vastus lateralis externus muscle (adults) 0.1 to 5 mL. 3. Vastus lateralis externus muscle (children) 0.1 to 1 ml. 4. Deltoid muscle (adults) 0.1 to 2 ml. 5. Ventrogluteus muscle (> 7 months) 0.1 to 5 ml. – The intramuscular route is contraindicated in the administration of anticoagulant treatments and adrenaline due to its irritant effect.
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