Procedimiento de Inyección Subcutánea
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geninazzimelanieProcedimiento de Inyección Subcutánea
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geninazzimelanieCommon questions
Con tecnología de IAIn oncology home care settings, subcutaneous injections serve as a practical alternative to intravenous administration, particularly when oral administration is not feasible . They provide an effective means to manage symptoms and treat conditions with fewer complications compared to intravenous routes . Additionally, subcutaneous injections allow patients to remain at home, fostering a more comfortable and familiar environment and reducing hospital visits, thereby improving the quality of care and life for terminal patients . This method is also easier for caregivers to manage, as it does not require the sterile environment or technical expertise associated with intravenous infusions .
For pediatric patients, special instructions for subcutaneous injections include selecting the injection site based on the child's age, weight, and nutritional status . The procedure should be explained to the child and family in an age-appropriate manner to reduce anxiety and ensure cooperation . The skin should be cleaned with alcohol and allowed to air dry before injection, and appropriate needle size should be chosen to minimize discomfort . Also, care must be taken to avoid injecting into bruised or swollen areas, and rotating the injection sites is crucial to prevent complications such as hematomas .
Subcutaneous injections have a slower absorption rate compared to intramuscular injections because the subcutaneous tissue has less vascularization . This slower absorption can be advantageous when a sustained drug release is desired, making it ideal for medications requiring gradual absorption . However, for drugs needing rapid systemic circulation, the intramuscular route might be preferred . This pharmacokinetic property must be considered when choosing between these routes for different medications.
There are two primary techniques for administering subcutaneous injections: the pinching technique and the stretching technique. In the pinching technique, the skin is pinched with the thumb and forefinger to form a fold, and the needle is inserted with the bevel up. After insertion, the fold is released to avoid compressing nerve endings, and the medication is injected slowly and evenly . This technique may be more comfortable for patients with less subcutaneous fat since pinching gathers the tissue more easily. The stretching technique involves stretching the skin at the injection site and inserting the needle in the center of the stretched area. This technique is often used when more resistance from subcutaneous tissue is expected, as stretching reduces tissue resistance . Both methods require careful attention to patient comfort and site selection.
The selection of the injection angle in subcutaneous drug administration is based on factors such as the volume of medication and the turgor (elasticity) of the patient's tissue . A shallower angle (45°) is typically chosen for patients with less adipose tissue or when injecting larger volumes to ensure the drug is delivered into the subcutaneous space rather than intradermally . A steeper angle (up to 90°) may be used in those with more turgidity or when administering smaller volumes, ensuring that the medication reaches the desired depth for optimal absorption . Incorrect angle selection can lead to inefficient drug delivery, either by introducing the medication too shallowly or too deeply, impacting its efficacy and potentially causing complications .
When selecting needles for subcutaneous injections, considerations include the length and gauge of the needle. Typically, needles with a medium bevel, 1.6 to 2.2 cm in length, and 24 to 27 gauge are used . These specifications ensure that the needle penetrates to the correct depth in the subcutaneous tissue without causing excessive tissue damage or discomfort, which can affect drug absorption and efficacy . Moreover, using the correct needle size helps minimize pain and reduces the risk of complications like bleeding or bruising, enhancing overall patient safety .
The subcutaneous route is beneficial for terminally ill patients who may have lost the ability to take oral medications, as it allows for effective symptom control while enabling patients to remain at home, thus improving quality of life . This method is simple to administer and has a low complication rate, making it suitable for home care . Additionally, it is comfortable and minimally disruptive for families and patients, ensuring smoother palliative care management .
Transparent dressings are beneficial for monitoring subcutaneous injection sites as they allow continuous visual inspection of the area without needing to remove the dressing, thereby preserving the sterile environment . This visibility aids in early detection of complications such as irritation, infection, or inflammation, enabling prompt intervention . Additionally, transparent dressings help ensure the proper positioning of any infusion devices and can reduce the discomfort associated with frequent dressing changes . They facilitate effective communication between healthcare providers and caregivers by enabling persistent monitoring, which is particularly important in home care settings .
Continuous subcutaneous infusions provide a steady, controlled release of medication, maintaining therapeutic drug levels consistently over time, which helps in the management of symptoms in terminal patients more effectively . This method mitigates the peaks and troughs associated with periodic bolus injections, reducing the risk of side effects and offer prolonged symptom control . Infusions also simplify medication administration, which is advantageous in home care settings, reducing the frequency of interventions necessary compared to bolus injections .
The complication risk in subcutaneous drug administration is relatively low, with the most common issue being local irritation at the injection site, occurring in about 2-3% of cases . Preventative measures include using the appropriate needle size and technique, rotating injection sites to avoid local tissue damage, and monitoring the injection site regularly for signs of irritation or infection . Applying a transparent dressing can help in early detection of site issues. In the case of irritation, changing the injection site is recommended to allow healing . Ensuring proper hygiene and technique can further mitigate these risks .
