Algorithm: the implementation of intravenous injection. Injection technique

Intravenous and intramuscular injections are the most common medical manipulations, the mastering of which is mandatory for all medical workers.

The necessary conditions

Intravenous injection is performed under the conditions of the manipulation room, in the ward of the hospital or in the resuscitation department. In exceptional cases, namely in the face of life threatening, intravenous injection can be performed at home or in transport. The drug, its dosage, frequency and duration of administration is chosen only by the doctor. Despite the presence of other routes of administration, intravenous injections (technique, algorithms) are a must for any health worker.

Anything that comes in contact with the vein should be sterile, as the medicine gets directly into the total bloodstream. Before the injection, you need to clarify all the details on the list of prescriptions, and if something is unclear, ask the doctor. It is also necessary to talk with the patient and find out from him whether any allergic reaction to the drug was noted before, what was the state of health after the injection. Especially nervous patients need to be reassured by explaining in simple terms the purpose of the drug. Immediately before the injection, you should wash your hands with soap and treat them with an antiseptic.

Algorithm: intravenous injection

For this manipulation it is required to prepare:

• A disposable syringe with a needle;
• Sterile cotton balls;
• Sterile gloves;
• Hard cushion from the oilcloth to the elbow;
• Burn;
• A file for ampoules;
• a drug;
• Closed containers for disinfecting;
• Closed containers for used needles, syringes and cotton balls (in extreme conditions all the waste material can be collected in one container).

Required security

First of all, you always need to think about the safety of your own and other patients. Materials in contact with blood carry the potential threat of HIV infection, hence the strict sanitary conditions. Intravenous injections are performed only with gloves.

If the gloves are not sterile, then after putting on they are processed with two balls with alcohol. Thus, the algorithm (the implementation of intravenous injection) involves double hand treatment: washing, treating the skin with an antiseptic and treating the gloves with alcohol. These actions are necessary in order to interrupt the transmission chain of a possible infection. This is especially important when you have to do a lot of injections. An algorithm for performing medical services (for example, intravenous injection) involves disinfecting not only the hands of staff, but also syringes, cotton balls, as well as couches, pads, rooms, ie, everything that biological traces could remain on. Compliance with the rules is the best way to protect all patients and yourself.

Sequencing

The algorithm (implementation of intravenous injection) implies the following actions.

1. Inspect the syringe and ampoule, check the appointment. With sterile hands, open the package with a syringe and collect it, put it in a sterile tray. Open the ampoule and dial the drug, completely releasing the air. At the same time, the cap must be put on the needle.
2. The patient should sit comfortably or lie, his hand is on a solid, fixed surface.
3. Exterior examination should find a well-visible vein. Most often this is the brachial vein, but sometimes the injection is made into the veins of the wrist. You need to look both hands and choose the best vein.
4. A hard pillow is placed under the elbow, and in the middle third of the shoulder a tourniquet is laid (on clothes or a dense napkin, you can use a towel). If the tourniquet is applied to the skin, then when squeezed, the patient will experience pain. The ends of the tourniquet should be directed to the health worker.
5. After the tourniquet is tightened, the patient is asked to press and unclench the fist several times. The vein should swell, become well visible and easily palpate with fingers. The patient holds his fist tightly.

Direct introduction

These actions are also included in the algorithm (intravenous injection). First, you need to treat a large area of skin with alcohol-moistened cotton balls - about 10 x 10 cm around the intended injection site. Then another ball is directly the injection site. The third ball is clamped with the little finger of the nurse's left hand.

Remove the cap from the syringe, take it in the right hand, the needle is placed upwards, the index finger fixes the cannula. The left hand covers the patient's forearm, while the thumb holds the vein and stretches the skin.

The technique of performing intravenous injection (algorithm) suggests that piercing the skin and vein should be at an angle of about 15 degrees, and then move the needle a half centimeter. The syringe is in the right hand, and the left one needs to gently pull the plunger onto itself, blood should appear in the syringe. The appearance of blood means that the needle is in the vein.

With his left hand remove the tourniquet, the patient unclenches his fist. Again pull the plunger, check the needle in the vein. Slowly push the plunger until the drug is completely injected. During the introduction, you need to closely monitor the condition of a person. Then quickly remove the needle, press the puncture with a cotton ball, bend the patient's arm in the elbow, leave to sit for about 10 minutes. Ask to straighten the arm, there should not be blood.

The algorithm of intravenous injection according to SanPin assumes that after the completion of injections the room is disinfected, and a medical record is entered in the medical documentation .

Algorithm of intramuscular injection

Preparation of the syringe with the drug and the hands of nurses are performed in a similar way. The patient needs to be laid on the couch face down. Intramuscular injections are best done when the patient is lying down, because a person can fall - all suffer the injection in different ways.

Conditional lines divide the buttock into 4 squares, the injection site - the upper outer. The skin is treated with two balls with alcohol: first a wide field, then the place of the injection itself. The syringe is held in the right hand, while the left is stretched at the injection site. With a sharp movement, the needle is inserted into the gluteus muscle, leaving 1/3 of the length outside. The angle of introduction is about 90 degrees (only in the thigh the angle of introduction is about 45 degrees).

The left hand pulls the piston, while the blood in the needle should not be. If the needle is in the vessel, make a new puncture. If there is no blood, slowly inject the entire drug. Take the third cotton ball and press it to the injection site. It is desirable that the patient has sat for several minutes, it is necessary to follow his reaction.

Where should I put the syringes and the balls after the injection?

The intramuscular injection algorithm assumes that everything that comes into contact with blood is a biological waste. Therefore, in the manipulation room should be the capacity:

• For washing syringes;
• For soaking used syringes;
• For used needles;
• For used cotton balls.

The tanks are filled with disinfectant, which is changed daily. The syringe with the needle is rinsed in the solution, then the needle and cap are detached and placed in a separate container. The washed syringe is disassembled, placed in another container. The balls are soaked separately. The syringes, needles and balls washed in disinfectant are disposed of under a contract with a disinfection establishment.

Which syringes are better?

For administration, as implied by the intramuscular injection algorithm, it is better to use syringes with a capacity of 5.0 or 10.0 ml. Most often the amount of the drug administered does not exceed 3.0 ml. These syringes are used because they have a long enough needle for the medicine to fall into the muscle mass and dissolve well there. For smaller syringes, the needle is thin and short, the medicine can get close to the skin. In addition, preparations for intramuscular injection are quite viscous, and injecting them with thin needles is inconvenient and painful.

Always, in all cases, even if the patient has been treated for a long time, it is necessary to clarify in him the likelihood of allergy and other adverse reactions. Also, the intramuscular injection algorithm assumes that the ampoule inscription should be read immediately before administration, even if the ampoule is removed from the box with the appropriate name. Errors in packing are rare, but still they happen.

Infusion: an infusion, an algorithm for conducting

Intravenous infusion is a quick way to improve a patient's condition. It differs from the injection from the injection volume only. If 10-20 ml is injected in a jet, then drip can be injected to 1 liter of liquid or more.

For the drip introduction of drugs using the PR system (solution transfusion). Manufacturers produce different models, the mandatory parts are:

• A long tube with a filter and an infusion rate controller;
• Air duct - a needle with a closed filter and a short tube;
• The needle is wide for puncturing the vial with the drug, the needle is puncture.

The algorithm for performing intravenous drip injection involves filling the system and actually introducing. The bottle is pierced with a wide needle, placed in a tripod. On a long tube, the regulator opens completely before filling with liquid so that the drug begins to drip from the puncture needle.

Then the system is connected according to the rules of intravenous injection. Under the needle put a ball with alcohol, the needle is fixed to the hand with an adhesive plaster. The lower the rate of administration, the less likely the occurrence of complications. After the end of the infusion, the patient lays on the couch for a while with the arm bent in the elbow until the blood is completely stopped from the puncture.