Some medications come ready-to-use, while others require you to fill the needle with medication from a vial. Be very clear on the supplies you need for the injection. Some people receive more than one type of injection at home. It is easy to confuse the syringes and needles needed for one injection with those intended for use with another medication injection.
Once you have talked to your doctor, you can also review the product literature, which will give clear step-by-step instructions on anything you need to do in order to prepare the medication for administration. Again, this is should not be considered a replacement for talking to your healthcare provider about how to prepare and administer the medication. The literature will also tell you the recommended syringe size, needle size, and needle gauge, if those are not included in the packaging. Give a medication packaged in a single dose vial. Common manufacturer packaging for many injectable medications is done by putting the medication into a vial called a single dose vial. The label on the medication vial will say either “single dose vial” or will contain the abbreviation, SDV. This means each vial contains only one dose. There may be fluid left in the vial after you have prepared the dose you need to give. The remainder of the medication in the vial is to be discarded and not saved for another dose.
Once you have talked to your doctor, you can also review the product literature, which will give clear step-by-step instructions on anything you need to do in order to prepare the medication for administration. Again, this is should not be considered a replacement for talking to your healthcare provider about how to prepare and administer the medication. The literature will also tell you the recommended syringe size, needle size, and needle gauge, if those are not included in the packaging. Give a medication packaged in a single dose vial. Common manufacturer packaging for many injectable medications is done by putting the medication into a vial called a single dose vial. The label on the medication vial will say either “single dose vial” or will contain the abbreviation, SDV. This means each vial contains only one dose. There may be fluid left in the vial after you have prepared the dose you need to give. The remainder of the medication in the vial is to be discarded and not saved for another dose.
The label on the medication will say “multi-dose vial” or contain the abbreviation, MDV. If the medication you are using is packaged in a multi-dose vial, use a permanent marker to write the date it was first opened on the container. Store the medication in the refrigerator between doses. Do not freeze the medication. Small amounts of preservatives may be used in the manufacturing process for medications contained in multi-dose-vial. This helps to minimize the growth of any contaminants, but only protects the purity of the medication for up to 30 days after the vial is opened. The vial should be discarded 30 days after the first date of opening has passed, unless your doctor advises you otherwise.
Remove the outer seal from the medication vial then wipe the rubber top of the with an alcohol pad. Always let the area air dry after wiping with an alcohol pad. Don’t blow on the top of the vial or the cleaned skin as this can cause contamination. Use the gauze pad or cotton ball to apply pressure on the injection site to reduce bleeding. Cover this with a band-aid. The sharps container is used as an important safety measure to protect the patient, caregiver, and community from biohazardous materials. The container is a thick, plastic, bin designed to hold used sharps. Sharps are lancets, syringes, and needles. When the sharps container is full, arrangements are made to transfer it to a place that destroys biohazard equipment. [3] X Trustworthy Source US Food and Drug Administration U. S. government agency responsible for promoting public health Go to source
Check the packaging for visible damage such as cracks or dents in the vial that holds the medication. Look at the area around the top of the vial. Check for cracks and dents in the seal around the top of the medication container. Dents can mean that the sterility of the packaging may no longer be reliable. Look at the liquid inside the container. Check for particulate matter which is anything unusual or floating inside the container. Most injectable medications are clear. Some insulins appear cloudy. If you notice anything other than clear liquid inside the container, other than some insulins products, then discard it.
Include washing your nail area, between your fingers, and your wrist area. This helps prevent contamination and reduce the risk of infection. It is recommended to wear FDA approved gloves such as Medint Latex Examination Gloves prior to an ejection as an extra barrier against bacteria and infection.
Examine the needle for any evidence of damage. Be sure the needle has not been bent or broken. Do not use any product that appears damaged including damage to the packaging that might indicate the needle is no longer considered sterile. Some packaged syringes and needles have a visible expiration date, but not all manufacturers provide this on the packaging. If you are concerned that a product is too old to use, contact the manufacturer. Have any lot numbers available when you call. Discard damaged or deteriorated syringes, or those that have expired, by putting them in a sharps container.
Select a syringe that holds a little more than the amount you need to administer. Follow the manufacturer’s recommendations regarding the needle length and gauge The needle gauge is the number that describes the diameter of the needle. Larger numbers mean skinnier needles. Some medications are thicker and need a smaller gauge, or larger diameter needle. Most syringes and needles are currently manufactured as a single unit for safety reasons. When you select your syringe size you are also selecting your needle length and gauge. Be sure you have the proper equipment to administer the injection. This information is detailed in the product literature, or is available by asking your pharmacist, doctor, or nurse. Separate syringes and needles are still available. If this is what you have, then assemble the syringe and needle. Make sure that the syringe is the proper size and the needle is sterile, unused, and the correct length and gauge for the type of injection you’re performing. Intramuscular and subcutaneous injections use different needles.
Sterilize the top of the vial with alcohol and allow it to air dry for several minutes. Prepare to fill your syringe. Know exactly how much liquid medication you need to withdraw and administer for your dose. Your syringe should contain exactly the amount of the prescribed dose. This information is available on the prescription label or the instructions provided by the doctor or pharmacy. To fill the syringe, pull the plunger back to fill it with air equal to the exact amount of fluid you will need. Holding the vial upside down, insert the needle into the rubber seal, and push the plunger to inject the air from the syringe into the vial. Pull the plunger out to withdraw the fluid to the exact amount needed for administration. [7] X Research source Sometimes air bubbles are visible in the syringe. Tap the syringe gently while the needle is still in the medication vial. This moves the air to the top of the syringe. Push the air back into the vial then withdraw more medication if needed to be sure you have the exact amount you need to administer.
Be sure you can comfortably reach the area of administration. Have the person remain as still and relaxed as possible. If you wipe the area with alcohol, wait several minutes for the area to air dry before inserting the needle into the skin.
One place that is good to give a subcutaneous injection is the abdomen. Select an area below the waist and above the hip bone, and about two inches away from the belly button. Avoid the belly button area. SQ injections can be given in the thigh area, halfway between the knee and hip, and slightly to the side as long as you can pinch up one to two inches of skin. The lower back is a good place for SQ injections. Target the area above the buttocks, below the waist, and halfway between the spine and the side. The upper arm is a usable site as long as there is enough skin to pinch up one to two inches. Use the area of the upper arm that is halfway between the elbow and shoulder. Alternating between sites will help prevent bruising and skin damage. You can also alter within the same general site by using different patches of skin within that area.
Do not touch the wiped area with your hands or any other material before giving the injection. Verify that you have the right drug, right site of injection, and that you have prepared the correct dose for administration. Hold the syringe with your dominant hand and pull the needle cover off with your other hand. Pinch the skin with your non-dominant hand.
Use a 45 degree angle if you can only pinch about one inch of skin. If you can pinch two inches of skin, then insert the needle at a 90 degree angle. Grasp the syringe tightly and use a quick motion of your wrist to puncture the skin with the needle. Insert the needle quickly and carefully at the determined angle with your dominant hand while pinching the skin with your other hand. Quick needle insertion helps prevent the patient from becoming tense. Aspiration for a SQ injection is not necessary. There is no harm in doing so unless you are administering blood thinning agents, such as enoxaparin sodium. To aspirate, pull the plunger back slightly and check for the appearance of blood in the syringe. If there is blood, then remove the needle and find a different spot to administer the injection. If no blood is found, continue. [11] X Research source
Remove the needle. Push down on the skin above the injection site and use a quick and careful motion to remove the needle in the same angle in which it was administered. The whole process doesn’t need to take more than five or ten seconds. Discard all used sharps in a sharps container.
Recognize the difference in syringes. Using a regular syringe can cause serious dosing errors. Insulin syringes are graduated in units instead of cc’s or mls. It is critical that you use an insulin syringe when giving insulin. Check with your doctor or pharmacist to be sure you understand which type of insulin syringe to use with your prescribed insulin type and dosage.
There are four primary sites recommended for administering IM injections. Those include the thigh, the hip, the buttocks, and the upper arm. Alternate between injection sites to prevent bruising, soreness, scarring, and skin changes.
Visually divide the thigh into three sections. The middle section is the target for the IM injection. This is a good site if you are giving yourself an IM injection since you can easily see and reach the target area.
Find the proper location by having the person lie on his or her side. Place the heel of your hand on the upper and outer part of the thigh where it joins the buttocks. Point your fingers toward the person’s head and point your thumb towards the groin. You should feel a bone along the tips of your ring finger and little finger. Form a V shape by moving your pointer finger away from the other fingers. The injection is given in the middle part of the V shape.
Draw an imaginary line, or actual line using an alcohol wipe if available, from the top of the crack to the side of the body. Locate the midpoint of that line, and move up three inches. Draw another line that crossed the first one, forming a cross. Locate a curved bone in the upper outer square or quadrant. The injection should be given in the upper outer square below the curved bone.
Find the acromion process, or the bone that crosses the upper arm. Draw an imaginary upside down triangle with the bone as the base and the point of the triangle is the level of the armpit. Give the injection in the middle of the triangle, one to two inches below the acromion process.
Do not touch the cleaned area with your fingers or any other material before giving the injection. Hold the syringe firmly with your dominant hand and remove the needle cover with your other hand. Put pressure on the skin where you are giving the injection. Push down gently and pull the skin so it is tight.
Aspirate by pulling the plunger back slightly. Look for blood that is pulled back into the syringe as you pull back on the plunger. If there is blood, then carefully remove the needle and find a different spot to administer the injection. If no blood is seen then continue with giving the injection. [20] X Research source
Do not push too hard on the plunger as this forces the medication into the site too fast. Push the plunger in a steady but slow manner to reduce pain. Remove the needle in the same angle in which it was injected. Cover the injection site with a small gauze pad or a cotton ball and a band-aid, and check on it regularly. Make sure it looks clean and the injection site is not continuing to bleed.
Signs of an allergic reaction include hives, a rash or itching; shortness of breath; difficulty swallowing; feeling like your throat or airway is closing; and swelling of the mouth, lips, or face. Call 911 if symptoms of an allergic reaction develop. You have just injected a medication into the body which speeds up the reaction time if an allergy is present.
Contact your doctor as soon as possible if you develop a fever, flu-like symptoms, headache, sore throat, joint and muscle aches, and gastrointestinal problems. Other symptoms that warrant prompt medical attention include chest tightness, nasal congestion or stuffiness, a widespread rash, and mental changes like confusion or disorientation.
Injection site reactions are more common with some drugs than others. Read the product literature before drug administration to know what to look for. Common reactions that occur at the site of an injection include redness in the area, swelling, itching, bruising, and sometimes a raised lump or hardened area. Alternating injection sites can help to minimize damage to the skin and surrounding tissue when frequent injections are needed. Persistent problems with injection site reactions warrant medical evaluation.
Never put lancets, syringes, or needles in the regular trash. Review your state’s guidelines. Your pharmacist can help you to find a program that meets your needs. Many states have clear guidelines and suggestions on developing a safe system for disposing of biohazardous waste created from giving injections at home. Sharps, including used needles, lancets, and syringes, are biohazardous waste since they are contaminated with skin and blood from direct contact with you or the person receiving the injections. Consider an arrangement with a company that provides mailback kits. Some companies provide a service that supplies you with sharps containers you need and make arrangements that allow you to safely mail the containers to them when they are full. The company takes responsibility for proper destruction of biohazardous waste. [27] X Trustworthy Source US Food and Drug Administration U. S. government agency responsible for promoting public health Go to source Ask your pharmacy about safe ways to discard any vials that contain unused medications. Often, any opened vials of medication can be placed into the sharps container.
