Basic injection techniques in medicine

In medicine, the drug is used through various routes such as oral, injectable, infusion, topical application,…. the most common of which remains oral and oral. Taking the drug is almost all patients can do it on their own, while injections mostly have to be done by medical staff.

In most tissues and cavities in the body it is possible to bring in fluids – drugs with injection procedures. In fact, there are several tissues that are often chosen to bring the drug into the body that are:

• In the skin.
• Under the skin: in the middle of the skin and muscles.
• In the muscles.
• In the veins.

The choice of tissue for the insertation of the drug into the body depends on the following factors:

Injection techniques are in place in the following cases:

• Emergency patients, serious diseases, need to work quickly.
• The patient vomits a lot, so it is impossible to take the medicine.
• The patient is preparing for surgery.

Intracutaneous injection routes are often used for diagnostic purposes, trying allergic reactions. Sometimes this technique is used in prevention such as vaccination and therapy.

Subcutaneous, intramuscular, intravenous techniques are mainly used in treatment, but can also be used for diagnostic purposes as well.

With the exception of intracutaneous injection techniques, the remaining injection techniques help the injection to diffuse or be inserted directly into the 3rcular system. In it the technique of intravenous injection, the drug will be introduced directly into the blood of the vein, so that the drug will have an immediate effect. Due to histic differences in muscle tissue and subcutaneous tissue, the rate at which the drug penetrates into the bloodstream will be in order as quickly as follows: intravenous injection is faster than intramuscular injection, then subcutaneous injection, and finally intracutaneous injection.

Because the tissues have different absorption, the amount of drugs introduced into the tissues during an injection is different. Namely the following:

• Intracutaneous injection is limited to 0.1ml.
• Intramuscular injection is limited to 3 – 5ml.

• Oil drugs are given only intramuscularly.
• Iron-containing drugs if injected subcutaneously can cause necrosis and cause inflammation.
• Preferred types of the epidemic can only be given intravenously.

• Always check before injection:
• Properly check the patient.
• Check the right medication.
• Check the correct dosage.
• Check the right technique.
• Check at the right time.
• Prevention of infection: injections of the drug are the intravenous application of the drug to the body, the natural protective barrier of the skin, the muscles are ruined, therefore it must be carried out with eptic tools and eptic manipulations.
• The spread of needles, syringes and blood-stained cotton should always be considered. Always store needles and syringes in separate containers. Don't leave the needle bare, because most likely we'll get stabbed by the needle, so the needle can no longer be used.

Healthcare workers need to perform 3 checks and 5 or 5 correct checks during the injection process for the patient.

• 3 tests include:
• Check the patient's name.
• Check the name of the drug.
• Check the dose of the drug.
• 5 reconciliations are:
• Compare bed number, room number.
• Reconciliation of drug labels.
• Reconciliation of drug quality.
• Reconciliation of the injection route.
• Compare the duration of the drug.
• 5 true include:
• That's the right patient.
• The right medicine.
• The right dose.
• The right injection.
• On time.

Identify patients through the following factors:

• Patient's senses.
• Patient age.
• The subcutaneous fat layer of the patient is thick or thin.
• How do patients move? Is there weakness, paralysis or normal movement?
• The type and quantity of use, the drug phase?
• Do you have allergies?

• Properly compare the patient.
• Explain to the patient to cooperate.
• Appropriate patient positioning.
• If the patient is severe, he or she needs help.

• Copy the prescription.
• Proceed to take the drug as prescribed, the 1st examination.
• Wear a mask, wash your hands often.
• Preparation of the injection tool tray:
• Spread the towel on a clean tray.
• Selection of injection pumps is suitable for the amount of drugs to be injected.
• The choice of needle is suitable for the injection line and injection site.
• Take the medicine needle.
• Cotton wool, iode alcohol disinfect the skin.
• Ball/clamp.
• Anti-shock drug box.
• Garo rope.
• Clean gloves.
• Quick hand antiseptic bottles.
• Medical waste bins sharpened with yellow hard plastic, one-way.
• Garbage bags containing yellow medical waste.
• Garbage bags containing blue household waste.

Preparation of injections:

• Get the drug from the ampop ampopes:
• Conduct antiseptic of the head of the drug tube, check for a second time.
• Saw the ampopes if necessary.
• Use dry cotton wool to wipe and break the medicine tube.
• Withdraw the drug into the syringe, hands must not touch the needle body and the intra-barrel of the syringe.
• Check the drug a third time, then put the case in the trash.
• Safely cover the needle, place the injection pump on top of the drug board in a safe injection tray.
• Get the drug from the vial:
• Open the lid of the vial, antiseptic, check for a second time.
• Get the water injected into the pump with a needle to get the medicine.
• Pierce the needle through the lid of the vial, pump distilled water into the vial.
• Suck the air back, then safely pull out the needle and shake the vial until the drug is completely dissolved.
• Insert the needle and pump the gas into the vial and then withdraw the medicine into the injection pump.
• Check the drug a third time, put the container in the trash.
• Replace the appropriate needle.
• Safely cover the needle, place the injection pump on top of the drug board in the safe injection tray.

Intracutaneous injection is the technique of inserting a prescribed amount of the drug as prescribed by the doctor into the epidermis. Here, the drug is absorbed into the bloodstream and causes a very slow effect.

Intracutaneous injection techniques are in place in the following cases:

• BCG vaccination against tuberculosis for infants.
• Mantoux reaction.
• Try the body's response to the drug, mainly with antibiotics, anaphylactic shock drugs such as Penicillin, Streptomycin,..

Needle size 26-27G, length about 0.6-1.3cm.

Injection site: usually on the sides of the shoulder blades (Delta muscles) or at 1/3 of the face in the forearm.

The injection angle is about 15 degrees from the surface of the skin.

The injection technique is as follows:

• Properly compare patients, notices and explanations.
• Reveal the injection area.
• Locate the injection.
• Wear clean gloves.
• Disinfect the injectable area with alcohol cotton in the direction from the inside out about 5cm, in a spiral.
• Hand antiseptic again.
• Exper off the air bubbles in the syringe.
• Tighten the skin of the injection area, place the beveled side of the needle on top, pierce the needle with an angle of about 15 degrees from the surface of the skin.
• Pump 0.1ml of the drug, at the injection site will swell.
• Quickly unpled needle in the direction of stabbing the needle.
• Use a pen to circle the injection site if you try to react, after 15 minutes of examination.
• Remove the gloves.
• Tell the patient not to touch the injection site.
• Notify and explain to the patient that the injection has been completed.
• Pack up tools and file records.

Subcutaneous injection is the technique of inserting an amount of the drug into loose connective tissue under the skin.

Subcutaneous injection techniques are in place in the following cases:

• Insulin injections.
• Cases where you want to put the drug slowly inside the body to develop a slowly.

Subcutaneous injection techniques are contrained in the following cases:

• Oil drugs are difficult to dissolve.
• The patient's skin has unfavorable problems for injection.

Needle: use a 25G needle, about 1 – 1.6cm long.

Injection angle: about 45 degrees compared to the surface of the skin, if the fat patient can inject at an angle of 90 degrees, and if the patient is thin, it can be injected with an angle of 15-30 degrees from the surface of the skin.

Injection site is usually in:

• Shoulder blades
• 1/3 of the outer side in front of the thigh
• Around the navel.

Subcutaneous injection technique:

• Properly compare patients, notices and explanations.
• Reveal the injection area.
• Locate the injection.
• Wear clean gloves.
• Conduct antiseptic injection area with alcohol cotton in the direction from the inside out about 5cm, in a spiral.
• Hand antiseptic again.
• Exper off the air bubbles in the syringe.
• Pinch the skin of the injection area, pierce the needle with an angle of about 45 degrees from the surface of the skin.
• Pull up the pittong to see if there is blood, if there is blood that needs to adjust the needle (draw the skin or stab it a little), check there is no new blood pumping slowly and observe the patient's face tone.
• Pull out the needle quickly in the direction of stabbing the needle.
• Place the dried cotton wool in the injection site and rub gently.
• Remove the gloves.
• Notify and explain to the patient who has finished the injection.
• Packing tools, recording records.

Intramuscular injection is the technique of inserting an amount of the drug into the muscles – in the muscles. When using this technique, the drug will work faster than subcutaneous injections.

Intramuscular injection techniques are in place in cases of isthat solution such as:

• Quinin, Ete.
• Oil solution: long soluble, easy to cause pain.
• Colloidal solution, mercury salt, silver salt, hormones, antibiotics … slow to dissolve, causing pain.
• All subcutaneously injectable drugs can be injected intramuscularly except caffeine.

Intramuscular injection techniques in case of organizational necrotic drugs such as Ouabain, Calci chloride,…

Needle: use a 21 – 23G fixed-sized needle, about 2.5 – 4 cm in length.

Injection angle: about 90 degrees from the surface of the skin.

Injection site:

• Shallow intramuscular injection:
• Cơ Delta.
• The amount of the drug should not exceed 1ml.
• No oil injections.
• Not used for 2015 Delta muscles: young < 2 tuổi.
• Deep intramuscular injection:
• Thighs: on 1/3 of the outer thigh. The amount of injections here is not more than 3ml.
• Buttocks: 1/4 on the outside take the hook is the upper front pelvic spine. The amount of injectables here is no more than 3-5ml.

Intramuscular injection technique:

• Properly compare patients, notices and explanations.
• Reveal the injection area.
• Locate the injection.
• Wear clean gloves.
• Conduct antiseptic injection area with alcohol cotton in the direction from the inside out about 5cm, in a spiral.
• Hand antiseptic again.
• Exper off the air bubbles in the syringe.
• Tighten the skin of the injection area, pierce the needle with an angle of about 90 degrees from the surface of the skin.
• Pull up the pittong to see if there is blood, if there is blood that needs to adjust the needle (draw the skin or stab it a little), check there is no new blood pumping slowly and observe the patient's face tone.
• Pull out the needle quickly in the direction of stabbing the needle.
• Place the dried cotton wool in the injection site and rub gently.
• Remove the gloves.
• Notify and explain to the patient who has finished the injection.
• Packing tools, recording records.

Intravenous injection is a technique that inserts the drug straight into the vein.

Intravenous injection techniques are in place in the following cases:

• Emergency patients.
• Severe illness needs to work quickly.
• The patient is depleted.
• Patients with mucosal damage, non-absorption or drugs destroyed by the gastrointestinal tract.
• Patients cannot take medication, vomit a lot, patients prepare for surgery, mentally ill patients do not cooperate.

Intravenous techniques are contrained in the following cases:

• Absolute contraintent to the place of burns, infection.
• Relative contrainteutics to the end of the paralyzed genus, where edema, avoid couplings.

Needle: use needle size 19 – 21G, length about 2.5 – 4cm.

Injection angle: usually an angle of 30 – 40 degrees from the surface of the skin, depending on the injection intravenous position.

Injection site: are peripheral veins, prioritizing the selection of large, clear, less mobile, soft, non-articular veins.

Injection techniques:

• Properly compare patients, notices and explanations.
• Reveal the injection area.
• Locate the injection.
• Wear clean gloves.
• Tie the garo wire at the top is injected about 5 – 10cm.
• Conduct antiseptic injection area with alcohol cotton in the direction from the inside out about 5cm, in a spiral.
• Hand antiseptic again.
• Exper off the air bubbles in the syringe.
• Tighten the skin of the injection area, place the beveled side of the needle on top, pierce the needle at an angle of about 30-40 degrees from the surface of the skin into the vein.
• Pull up the pittong to see if there is blood, if there is no blood need to adjust the needle (draw the skin or stab a little), check if there is new blood removing the garo cord, then pump the drug slowly and observe the patient's face tone.
• Pull out the needle quickly in the direction of stabbing the needle.
• Place the dried cotton wool in the injection site and rub gently.
• Remove the gloves.
• Notify and explain to the patient who has finished the injection.
• Packing tools, recording records.

• Tool cleaning:
• Return the medicine card to the correct place or leave it in the waiting box for the next time.
• Carry out the treatment of injection tools in accordance with the sterilization and sterilization procedures.
• Other tools return the old place as the cover ,…
• Record dossiers and medical records:
• Specify the date and time of the injection.
• Specify the name of the drug, dosage, route and injection site.
• Record the patient's reaction if any.
• Specify the full name of the implementer.

The above are 4 basic injection techniques commonly used in medicine. Most of these techniques are performed by trained medical staff. However, there are also some cases where patients can do it themselves after being instructed by health workers such as patients who inject Insulin daily,…

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