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General Care of the Patients

Injections

Not yet clinically reviewed

This protocol was migrated from the earlier Pharmapedia and Ward Guide apps for educational use. Follow your hospital's own policies and consult seniors when in doubt.

Equipment Syringes

Disposable or reusable—2.5, 5, 10, 20, 30, 50 ccs. Insulin syringes—concentration of insulin marked in units, e.g., U-80, etc.

  • Tuberculin syringes—each small division 1/100 cc. Barrels and plungers are interchangeable.

Needles: Disposable or Reusable

Vary in length from 3/8

  • 1.2 inches
  • Outside diameter measured by stub gauge and indicated by numbers 14-27 SG’s. Higher the gauge, smaller the diameter (Table 31.1).
  • Criteria for selection depends on route, viscosity of medicine, amount of medication, body size and fat. Sterilization: By autoclaving or by boiling for 10 minutes or use disposable syringes. While using disposable syringes take care to dispose of them appropriately.

Sites of Injection

Intradermal: Anterior aspect of forearm

  • Subcutaneous: Outer aspect of upper arm, anterior abdominal wall, anterior and lateral aspect of thigh
  • Intramuscular:

Upper outer quadrant of buttocks

Lateral aspect of the thigh

Outer aspect of shoulder (mid-deltoid site)

  • Intravenous: Veins of forearm, cubital fossa, radial vein, veins of foot, femoral vein and scalp veins—avoid veins of lower limb as far as possible as the risk of venous thrombosis is more.

INTRAVENOUS INFUSION

Fluid Requirement

  • Newborn: 80–100 ml per kg body weight
  • 0–1 year: 100–150 ml per kg body weight
  • 1–2 year: 100–125 ml per kg body weight
  • 2–10 year: 70–100 ml per kg body weight
  • 11–18 year: 50–75 ml per kg body weight
  • Adults: 40 ml per kg body weight
  • Fluid loss: Kidney—about 1500 ml/day (with average fluid intake). Lungs, skin and intestine—about 600 ml/ day.

Complications of IV Infusion

  1. Circulatory overload: Leads to pulmonary oedema Prevented by — Regulating flow rate — Exclude any cardiac lesion before IV infusion
  2. Bleeding/Hematoma: Apply pressure locally to control bleeding; cold compress later.
  3. Thrombophlebitis: Apply warm moist compress, do not massage or rub the area, change IV site.
  4. Pyrogenic reaction: Usually 30 minutes after infusion is started. Antihistaminic and tepid sponging, change the IV set, IV cannula and IV fluid.
  5. Air embolism: Precaution: Remove air bubbles, close IV line immediately on completion of the infusion