Intramuscular injection (IM)
Definition: An intramuscular injection is a method used to administer medications into the
deep muscle tissue. Medications will be absorbed quickly due to the richly supplied blood
vessels in the muscle.
Advantages
1. -Rapid action than oral route as in IM, most aqueous medications are absorbed in
10-30 minutes.
2. -large volume can be administered than in Subcutaneous in developed muscles of
adult
3. Less sensitive to irritating and viscous drugs than intravenous injection
4. If there’s contraindication to the oral route (example: unconscious patient. Surgery)
Disadvantage
1. Risk for Infection
2. Risk for nerve, tissue injury
3. Painful
Variables governing the risk of injury include:
● Anatomical site of injection
● The length of the needle
● The angle of injection
● Position of the patient during injection and
● The expertise of the health personnel
Contraindication
1-Muscle atrophy as in paralyzed patient
2-Reduce blood flow to the muscle as in vascular disease, embolism
3-Circulatory shock as blood flow to muscle is very weak
4- Sometimes Patients with coagulation disorders as in liver disease
Sites of intramuscular injection
The most common sites for intramuscular injections
1-The vastus-lateralis
Muscle is located on the anterior lateral aspect of the thigh in the middle third. This is easily
accessible site and is the preferred site for clients of all ages since it has no major blood
vessels or nerves nearby. Its thick, well developed but small nerve endings resulting in
discomfort after injection
Position
● Supine with knee flexed
● Sitting
Volum of injectable drug: (1ml:3ml)
2-Rectus femoris
It is located on the anterior aspect of the thigh. Injection in the middle third of the anterior
aspect of the thigh.
N.B Used for small doses of medications
Position
● Supine with knee flexed
● Sitting
Volume of injectable drug: (1:2ml)
3-The ventro-gluteal muscle
It is also safe for all clients and involves (the gluteus medius &minimus). Since it is located
deep and away from major blood vessels and nerve, its located by pointing the thumb
towards the patient groin and index finger over the anterior superior iliac spine and extends
the middle back along the iliac crest toward the buttock, inject in the center of the V shape
formed by index and middle finger.
Position
● On either side, with knee bent and upper leg on the bottom leg
● Supine
● Prone
Volume of injectable drug: (up to3ml)
4-The dorsogluteal it is the traditional site for an intramuscular injection in the upper outer
quadrant of the buttock. It’s located by dividing the buttocks into four quadrants and injecting
in the upper outer quadrant, it is lateral and slightly superior to the midpoint of a line drown
from the greater trochanter to the posterior iliac spine; however, there is greater risk of
damage to the sciatic nerve, major blood vessels, and the greater trochanter bone. It should
not be used in children less than 5 years of age since this muscle is not developed. Preferred
in obese or over weight patient.
Position
● Prone with toes pointing inward
● On either side with the upper leg flexed and in front of the lower leg
Volume of injectable drug: (up to5ml)
5-The deltoid muscle is found on the upper arm about 1 to 2 inches below the acromion
process. Place four fingers with the top finger along the acromion process and inject in third
finger width in the center of the muscle. Major nerves and blood vessels are beneath this site
and only small volumes of medication should be injected.
N.B:
● Not well developed in many adults so used when other sites are not accessible as in
cast.
● Only for small doses (0.5-1ml)
● Avoid injection in middle or lower 1/3 of the upper arm because it might injure the
radial nerve
● Hepatitis vaccine should be given only in this muscle
Position
● Sitting or lying down with arm relaxed and elbow flexed with exposing the upper arm
and should
Preparations:
a) Nurse:
● Hand washing and wearing gloves: to prevent cross infection.
b) Patient
● Assess patient’ chart for written physician order (five rights): name, dose, route, time,
and frequency to Ensures patient receives correct medication
● Assess patient for contraindication that may influence an injection, such as circulatory
shock, or muscle atrophy to as in these cases, reduced tissue perfusion will interfere
with the absorption and distribution of the drug
● Explain procedure to the patient to decrease fear and anxiety
● Assess for previous intramuscular injections in order to rotate sites and avoid
repeating injection in the same site which may lead to lump formation
● Assess site of injection that should be free from Inflammation necrosis, bruising,
tenderness, lumps, nodules on palpation
Suitable for the volume of medication for good absorption of medication
c) Equipment
Equipment Needed
● Tray
● Solvent (sterile water) if needed
● Medication card with five rights.
● Container for disposing sharp waste product.
● Syringe (with different size).
● Dry cotton sponge and others with alcohol.
● Medication ampoule or vial.
● Medication administration record (MAR)
● Disposable glove
● Paper bag
D) Environment
● Provide for privacy by pulling curtains.
● Close doors and windows to prevent air draft
● excuse visitors to prevent patient embarrassment
Procedure
Step Description
Prepare medication assess for
- Check right name of medication, dose,
expiration date & inspect for any
discoloration
-Check syringe for expiration date and
complete closure
Drawing up the medication into the
syringe from ampoule:
1. Open syringe cover
2. Attach and tighten the needle
into the syringe.
3. Check efficiency of syringe - To detect any problem before aspirate
medication
4. Tap the top of ampoule, wrap - To dislodge medication from ampoule neck for
neck with cotton sponge and correct dose the cotton sponge protect the nurse
from being injured by the jagged edge of the
break it off away from you broken ampoule. The outward motion provides
additional safety for the nurse
5. Take the needle cap off the
needle and place the cap on
the tray, hold ampoule in
non-dominant hand
6. Insert needle into ampoule - To maintain needle sterile
without touching rims and
aspirate with bevel under the
level of medication or invert
ampoule and place the needle
into the liquid
7. Recap the needle carefully by
holding the barrel
8. Point syringe vertically and pull - To expel air bubbles from the syringe
back plunger without touch
Aspirate medication from vial
9. Open syringe cover
10.Attach and/or tighten the
needle into the syringe
11. Check efficiency of syringe
12.Remove vial cover without - To maintain needle sterile
touch or disinfect the vial top
with an alcohol sponge
13.In case of vial contains
powder, dissolve powder with
distal water by injecting this
water into vial and shake it well
14.Draw air into the syringe equal - To facilitate aspiration of medication
to the amount of medication if
required
15.Take the needle cap off the
needle and place the cap on
the tray.
16.Insert the needle into the
rubber stopper on top of the
vial properly
17.Inject air into vial, don't cause
turbulence
18.Turn the vial upside down to
withdraw the correct volume of
medication
19.Remove needle from vial
20.Recap the needle carefully
21.Exmina for air bubbles and
expel them
22.Carry medication tray with
paper bag containing syringe
with medication, dry cotton,
alcohol swab & clean gloves
23.Introduce yourself to the
patient
24.Explain procedure to the To decrease fear and anxiety & gain patient
patient - cooperation
25.Wear clean disposable gloves
26.Select the correct site, palpate - Palpate to ensure that site is free from
the site and disinfect it with tenderness, nodules or lump. The alcohol at the
injection site helps reduce microflora and
alcohol and ensure skin is dry decreases the potential of introducing pathogens
before injection into the client's tissue
27.Position patient in appropriate - To facilitate insertion of needle and prevent
position according to selected injury
site and instruct patient to
relax muscle
28.Support the needle & remove
needle cap
29.Pinch the skin in thin patient or To facilitate insertion and penetration of the
spread skin in obese patient needle and to decrease pain sensation
with nondominant hand as
indicated
30.Insert 2/3 needle at 90°-degree
angle, then support the hub
with nondominant hand
31.Check to see if blood is going To avoid injected medication intravascular
into the syringe by pulling back instead of intramuscular
the plunger (aspiration) if blood
appears withdraw the needle
in the same angle, discard
syringe, prepare new injection
and start again, if no blood
return, inject slowly.
32. Inject medication gradually
and slowly while supporting
needle with nondominant hand
33. Remove needle at the same To avoid injury to tissues
angle of insertion
34.Press on or message the site Press in if medication is irritated, to avoid skin
gently with a dry sponge irritation
Massage promote absorption
35. Assist the patient to a comfort
position
36. Discard syringe and needle in
sharp container (safety box).
Do not recap the needle
37. Discard disposable items
according to infection control
precaution (in biological
hazard container)
38. Wash hands To prevent cross infection
39. Document the following in
patient record: date, time,
name of medication, route,
dose, site, patient's reaction.
Z-track technique
Originally the Z-track method of intramuscular injections was used as a special procedure for
only certain medications. Medications such as iron dextran can be irritating to the tissues and
stain the skin. Using the Z-trac method prevents potentially irritating medications from being
tracked up through the tissues by interrupting the injection tract. This method can help
reduce pain with staining or irritating substances.
1- With the syringe at eye level, draw up the medication with a large-bore needle.
Remove the large-bore needle and replace it with a needle of the appropriate
size and length for the client
2- Add 0.1-0.2 ml of air to the dose in the syringe. The air will push the medication
out of the needle when the last of the medication has been injected
3- Using your non-dominant hand, pull the skin and subcutaneous tissue to the
side or downward about an inch
4- While maintaining traction on the skin, using your dominant hand, dart the
needle into the skin at a 90-degree angle.
5- Allow the needle to stay in place for10 seconds after the medication is injected.
This allows the medication to diffuse before the needle is removed, which
decreases the chance that any medication will be tracked back up through the
skin
Intradermal Route ID
Definition: is the shallow and superficial injection of a medication into dermis where blood
supply is reduced and drugs absorbs slowly, it is useful route for allergic testing
Purpose of intradermal injection
• Skin testing such as tuberculin screening (72 hr)
• Allergy testing. Only small amounts (0.01-0.10 ml) of medication are given intradermal
The most common sites for injections
● Inner aspect of Forearms, upper chest and upper back
● The site should be lightly pigmented, free of lesions and hairless. Since these areas
are easily accessible and nurse can monitor the reaction.
Preparation:
1. Nurse:
● Hand washing to prevent cross infection
● Put on gloves
2. Patient:
● Review written physician ‘s order
● Assess for the indications for intradermal injection including the patient ‘s allergy
history so the nurse will not administer a substance to which the patient is known to be
sensitive.
3. Equipment:
● Tuberculin syringe, insulin syringe
● Antiseptic or alcohol swabs
● Medication ampoule or vial
● Medication card
● Disposable gloves, pen.
4. Prepare environments
● Close door or curtains close door to Provides privacy.
Procedure
Nursing action Rational
Prepare medication assess
medication for:
- Check right name of medication,
dose, expiration date & inspect for
any discoloration
- Check syringe for expiration date
and complete closure
Aspirate medication from vial
1. Open syringe cover
2. Attach and / or tighten the needle
into the syringe
3. Check efficiency of syringe
4. Remove vial cover without touch To maintain needle sterile
or disinfect the vial top with an
alcohol sponge
5. In case of vial contains powder,
dissolve powder with distal water by
injecting this water into vial and
shake it well
6. Draw air into the syringe equal to To facilitate aspiration of medication
the amount of medication if required
7. Take the needle cap off the
needle and place the cap on the tray
8. Insert the needle into the rubber
stopper on top of the vial properly
9. Inject air into vial, don't cause
turbulence
10. Turn the vial upside down to
withdraw the correct volume of
medication (0.01-0.1)
11. Remove needle from vial
12. Recap the needle carefully
13. Examine for air bubbles and
expel them
14. Carry medication tray with paper
bag contains: syringe with
medication, dry cotton, alcohol swab
& clean gloves
15.Identify patient and explain Assures medication is given to right patient and
procedure decrease fear and anxiety
16.Select injection site Injection site should be free of lesions
- Forearm site should be 3-4 finger
widths below antecubital space and
one hand width above wrists on
inner aspect of forearm
17.Assist patient into comfortable Relaxation minimizes discomfort
position
18.Forearm site: Relax the arm with Relaxation minimizes discomfort
elbow and forearm extended on a
flat surface
19.Use antiseptic swab in a circular Circular motion and mechanical action of swab
motion to clean skin at site remove microorganisms
20.While holding the swab between Swab remains accessible during procedure.
fingers of non-dominant hand, pull Prevents contamination of needle
cap from needle
21.Administer injection Needle penetrates tight skin easier than loose
skin
22.With non-dominant hand, stretch Ensures needle tip is in the dermis
skin over site with forefinger and
thumb
23.Insert needle slowly at a 5- to
15-degree angle bevel up until
resistance is felt. The needle tip
should be seen through the skin
24.Do not aspirate. Slowly inject the
medication
25.Resistance will be felt
26.Note a small bleb, like a
mosquito bite, forming under the
skin surface
27.Withdraw the needle while Prevents medication from being dispersed into
applying gentle pressure. Do not the tissue and altering test results
massage the site
28.Draw circle around site and avoid
scratch the site, wait for 20-30 min
29.Assist the patient to a Promotes comfort
comfortable position
30.Discard the uncapped needle Decreases risk of needle stick
and syringe in a safety box
31.Remove gloves and wash hands Reduces transmission of organisms
32.Document Date and time of skin
reaction and any systemic side
effects of the medication (redness,
swelling, severe pain)
- Report to physician
Subcutaneous injection
A subcutaneous injection is a method used to administer medications into the loose
connective tissues just below the dermis of the skin.
N.B:
● Only small (0.5- to 1-ml) doses of isotonic, nonirritating, non-viscous, and
water-soluble medications should be given subcutaneously, such as insulin, tetanus
toxoid, epinephrine, and. If larger volumes of medications remain in these sensitive
tissues, a sterile abscess could form, causing a hard, painful lump.
Advantages: medication are absorbed slowly due to less richly supplied blood vessels in the
Subcutaneous tissue and this give prolonged effect
Contraindication
● In sites that are inflamed, edematous, scared, or covered by mole, birthmark or other
lesion
● Sometime in patients with impaired coagulation mechanisms
Sites of subcutaneous injection
● Outer aspect of the upper arm
● Abdomen(from below the costal margin to the iliac crests)
● Anterior aspects of the thigh
● Upper back
● Upper ventral or dorsogluteal area
Preparation:
A) Nurse:
● Hand washing and gloving to prevent cross infection
B) Patient
1. Review physician ‘s order so that the drug is administered safely and correctly. Assess
patient’ chart for written physician order (five rights): name, dose, route, time, and
frequency
2. Assess patient for factors that may influence an injection such as circulatory shock or
reduced local tissue perfusion since reduced tissue perfusion will interfere with the
absorption and distribution of the drug.
3. Assess for previous subcutaneous injections in order to rotate sites and avoid
repeating a dose in the same site.
C) Equipment
● Syringe appropriate for the medication
● Antiseptic or alcohol swabs \ dry
● Medication ampoule or vial
● Disposable gloves
● Paper bag
D) Environment
● Provide for privacy by pulling curtains.
● Close doors and windows to prevent air draft and excuse visitors to prevent patient
embarrassment
Procedure
Nursing action Rational
A. Prepare medication assess
medication for:
- Check right name of medication, dose,
expiration date & inspect for any
discoloration
- Check syringe for expiration date and
complete closure
Drawing up the medication into the
syringe from ampoule
1. Open syringe cover
2. Attach and tighten the needle into the
syringe.
3. Check efficiency of syringe To detect any problem before aspirate
medication
4. Tap the top of ampoule, wrap neck with To dislodge medication from ampoule's neck
cotton sponge and break it off away from for correct dose the cotton sponge protects the
you
nurse from being injured by the jagged edge of
the broken ampoule
The outward motion provides added safety for
the nurse
5. Take the needle cap off the needle and
place the cap on the tray, hold ampoule in
non-dominant hand
6. Insert needle into ampoule without To maintain needle sterile
touching rims and aspirate with bevel under
the level of medication or invert ampoule
and place the needle into the liquid
7. Recap the needle carefully by holding the
barrel
8. Point syringe vertically and pull back To expel air bubbles from the syringe
plunger without touch
Aspirate medication from vial
9. Open syringe cover
10. Attach and / or tighten the needle into
the syringe
11. Check efficiency of syringe
12. Remove vial cover without touch or To maintain needle sterile
disinfect the vial top with an alcohol sponge
13. In case of vial contains powder, dissolve
powder with distal water by injecting this
water into vial and shake it well
14. Draw air into the syringe equal to the To facilitate aspiration of medication
amount of medication if required
15. Take the needle cap off the needle and
place the cap on the tray.
16. Insert the needle into the rubber stopper
on top of the vial properly
17. Inject air into vial, don't cause
turbulence
18. Turn the vial upside down to withdraw
the correct volume of medication
19. Remove needle from vial
20. Recap the needle carefully
21. Examine for air bubbles and expel them
22. Carry medication tray with paper bag
contains: syringe with medication, dry
cotton, alcohol swab & clean gloves
23. Identify and Explain procedure to
patient
24. Select injection site and Inspect skin for
bruises, inflammation, edema, masses,
tenderness, and sites of previous injection
25. Use antiseptic sponge to disinfected Circular motion and mechanical action of swab
skin at site. remove microorganisms
26. Pull cap from needle with non-dominant
hand and Hold syringe between thumb and
forefinger of dominant hand like a dart.
27. Pinch skin with non-dominant hand and Needle penetrates tight skin easier than loose
measure skinfold Inject needle quickly and skin. Pinching skin elevates subcutaneous
firmly (like a dart) at a 45 (cachexic patient) tissue. Quick, firm injection minimizes
to 90-degree angle discomfort.
28. Release the skin and support the hub of
the syringe with non-dominant hand and
slowly inject the medication
29. Remove needle at the same angle of To avoid injury tissue
insertion, apply pressure with dry cotton
30. Assist the patient to a comfortable
position
31. Discard the uncapped needle and Decreases risk of needle stick
syringe in a safety box
32. Remove gloves and wash hands Reduces transmission of microorganisms
33. Document the following in pt record:
Date, time, name of medication, dose,
route, site, patient reaction
Intravenous Route IV
Intravenous therapy (IV therapy) is a method of giving medication directly into a vein.
N.B Compared with other routes of administration, the intravenous route is the fastest way to
deliver fluids and medications throughout the body. Some medications, as well as blood
transfusions, can only be given intravenously.
Purposes and Indications for IV cannulation include the following
● To supply fluid when patients are unable to take in an adequate volume of fluids by
mouth
● To provide salts and other electrolytes needed to maintain electrolyte balance
● To provide Nutritional support, parenteral nutrition
● To provide water-soluble vitamins and medications
● To establish a lifeline for rapidly needed medications and blood transfusion.
● To administer Chemotherapy
● Administration of radiologic contrast agents for computed tomography (CT), magnetic
resonance imaging (MRI), or nuclear imaging
Potential complications
● Hematoma
● Hemorrhage
● Infection
● Thrombophlebitis
● Puncturing an artery or nerve
● Extravasation
● Air embolism
N.B
● In Hypovolemia; use larger veins. That produce high infusion rate
● Use veins of non-dominant side consult with patient if in doubt Terminate after two
attempts and seek assistance.
● Start from distal to proximal vein
Intravenous Fluids
There are two types of fluids that are used for intravenous drips; crystalloids and colloids
solutions.
Crystalloids: Many of the best-known types of intravenous fluid fall under the general class
of crystalloid solutions. These solutions contain chemicals with small molecules which can
easily pass through the walls of capillaries into the body’s cells. These fluids are divided into
three groups,
● Hypotonic: crystalloid fluids, such as half-strength saline solution with 0.45% salt,
have fewer electrolytes than plasma and are frequently used to hydrate patients.
● Isotonic fluids match the body’s electrolyte level. These solutions, which include a 5%
dextrose sugar solution, 0.9% saline solution, and lactated Ringer’s solution, serve a
range of functions as increase blood volume(hypotension)
● Hypertonic fluids, which have high concentrations of electrolytes, include
double-strength 10% dextrose and 5% dextrose in saline solution
These fluids can fill blood vessels by withdrawing water from cell as in cerebral edema.
Colloids: Colloids contain larger insoluble molecules, such as gelatin; as blood and intralipid.
Colloids preserve a high colloid osmotic pressure in the blood, while, on the other hand, this
parameter is decreased by crystalloids due to hemodilution. Another difference is that
crystalloids generally are much cheaper than colloids. Colloids have large particles in them
so they are not as easily absorbed into the vascular bed. Because of this property colloid are
used to replace lost blood, maintain healthy blood pressure, and volume expansion
Preparation
Nurse preparation:
● Hygienic hand washing and wearing gloves: to prevent cross infection.
Prepare the patient:
● Review medical record for diagnosis and any disorders affecting coagulation process.
● Assess vital signs and central venous pressure (CVP) for baseline data
● Assess skin turgor, intake and output chart
● Assess any allergy to latex, tape
● Assess Status of veins to determine appropriate venipuncture site, this vein should be
Patent, Palpable, Distal, Straight, full, spongy
● Avoid vein which near to joint flexion, near to arteries or pervious surgery as
mastectomy and fistula, and veins which are hard and sclerotic.
Prepare medication
● Check written doctor’s order
● Check the type and amount of solution to be infused
● Check The exact amount (dose) of any medications to be added to a compatible
solution
● Check The rate of flow or the time over which the infusion is to be completed Check
expire date.
Equipment Needed:
● Suitable IV catheter (cannula)
● Tourniquet
● Disposable gloves
● Antiseptic solution and cotton sponge
● Stripes of plaster
● Syringe with 1cm saline for checking patency,
● Infusion set
● IV fluid &IV stand
● Kidney basin
● Medication card
Procedures
Procedure Rational
How to prepare infusion:
1. Wash hands. Apply gloves Reduces the transmission of microorganisms
2. Draw up any additives ordered by the Ordered additives may come in vials, ampoules, or bags
physician
Adding Medication to IV Solution:
3. Prepare IV bag by removing protective Allows for access to the injection port
cover
4. Inspect bag or bottle for leaks, tears, or Prevents infusing contaminated or outdated solution
car Caracks .inspect the fluid for clarity color
and cheek Expiration date
- For plastic IV bag, locate port with rubber
stopper or at the IV injection site
5. Add medication to IV solution
- For plastic IV bag, locate port with rubber
stopper or at the IV injection site
- Insert needle into center of port or bottle
- Avoid use of port of the IV tubing or air
vent
6. Mix medication into IV solution by gently Ensures even distribution of medication throughout the solution
turning the bag from end to end
7. Label the bag Informs nurses and doctors regarding medication added to the
Write the name, dose of medication, date, solution
and nurse’s initials Allows easy visualization when Bag hanging
Apply it to Bag upside- down
Store the prepared solution in the area Keeps prepared solution readily available for when it is needed
assigned it by an institution
Insertion of IV Cannula:
1. Assemble equipment. Provides easy access to items. To save time and effort
2. Explain procedure to patient To decrease fear and anxiety, gain cooperation
3. Apply tourniquet above the site 4-6 To impede venous return
inches (10-15cm)
4. Visualize and palpate the vein. To ensure accurate insertion
5. Disinfect the site with alcohol sponge in
one direction (at least 3 swabs)
6. Remove the cannula from the package
and inspect catheter
-Push down on the flashback Chamber to
ensure it is tight]
-Inspect the catheter and needle for any
damage or Contaminantes
-spain the hup of the catheter to ensure that
it moves freely on the needle
-Don’t move the cannula tip over the bevel
of the stylet
7. Stabilize the vein by pulling the skin
against
8. Insert the stylet through the skin with
angle 30°, then reduce the angle through
the vein.
9. Observe for 'flash back' as blood slowly
fills the flash back chamber.
10. Advance the needle approximately 1 cm
further into the vein.
11. Remove the tourniquet.
12. Holding the end of the catheter with To avoid penetration of vein
thumb and index finger, pull the needle
(only) back 1 cm
13. Slowly advance the catheter into the
vein while keeping tension on the vein and
skin.
14. Occlude the distal end of the catheter
with the 3rd, 4th and 5th fingers of your
nondominant hand.
15. Secure the catheter hub with your thumb
and index finger and carefully remove the
needle stylet and cover it
16. Secure the catheter By small part of the To ensure patency of cannula
adhesive tape over the lower half of the
catheter hub until flashing the catheter with
normal saline a patient complete
securement of cannula taking care not to
cover the IV tubing connection
17. Place the needle into the sharps
container.
18.Label the cannula with date, time and As cannula should be removed after three days if patient
signature
How to give infusion into cannula:
1. Remove the cover from the end of the IV
tubing and insert the IV tubing into the hub
of the catheter.
2. Secure the tubing to the catheter by
screwing the lock tight.
3. Open up the IV roller clamp and observe
for drips forming in the drip chamber.
4. Check that the IV is infusing into the vein
By occluding the vein distal to The catheter
and observing that that drips stopped
forming and then restart once the vein is
released
5. Ensure that the IV is properly secured
and infusing properly.
Adding Medication to an Existing
Solution:
1. Identify patient using arm band and Ensures correct patient received the medication
calling name
2. Explain the purpose of the medication Information reduces anxiety
and how it will be given
3. Clamp the IV tubing and remove bag from Prevents medication from being infused rapidly.
IV pole.
4. Wipe off port or site with antiseptic swab. Reduces transmission of microorganisms.
A Insert needle into center of port or site
b. Inject medication into bag. • Facilitates adding medication to
c. Remove needle from bag • Injection ports are self-sealing.
5. Apply a new label: Informs nurses and doctors regarding medications added to the
a. Write the name and dose of solution.
medication. Write date, time, and
nurse ‘s initials.
b. Apply to bag upside-down. • Allows easy visualization when bag is hanging
6. Unclamp the tubing and regulate the flow Prevents rapid infusion of the medication
7. Remove gloves and dispose of all used Reduces transmission of organisms
materials appropriately.
8. Wash hands. Reduces transmission of organisms
9. Document the preparation of the IV Provides a record to ensure continui of care.
solution
10. Note the date, time, solution, volume,
medications added.
Remove Cannula:
Remove the tape from the tubing and
cannula and place cotton sponge over the
IV site and remove the cannula from the
arm and secure it in place with a piece of
tape.
