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Subcutaneous Injections

This is a demonstration of a subcutaneous injection. I am here with Mr. Kelly who is going to help me demonstrate this skill. I have my MAR, my computerized MAR. This might be out in the hall when you do the beginning part of it or someplace else you might do the first couple of steps or you can be at the bedside with it just depending upon your system. So, I verified my patients identification. I know that this is Mr. Kelly. I have checked his wristband and I verified. I have my medication software open here and I am going to scan his wristband which opens up his MAR and as this opens up I can verify again that this is Mr. Kelly’s MAR with his birthdate etc., on here. I am looking at his allergies and I am going to go to the time of day whatever that is that we are giving this medication and I am only giving one medication so I am looking up that one medication on the MAR. So I am giving anti-coagulant today and I would find it on my MAR and I would pull it out of the drawer. It would be labeled and I would check it all the way across my MAR for all the particulars that I have to have about this medication and then I would check it a second time completely, all the way across. So I would check it two times making sure that this is the correct medication, the dosage that I am giving it sub q, the time and everything that I need and all the rights and I have verified of course that this is the right patient. So, after I have checked it two times I want to be sure that I a ready to go in and give the injection and I have done my hand hygiene, wash my hands. I am going to put on gloves for this. I know that Pearsons says that gloves are optional, but generally we recommend gloves for an injection. I am going to need an alcohol prep pad and a 2×2 with me. And I have already talked with Mr. Kelly about his injection and he gets the regularly, so he is familiar. So, I am going to take my third check here, one last time. All of the same things that I am checking again. So that I have checked the medications three times, then I will scan it and I will not get an error message or anything if it is the correct med at the correct time which is one of the safety features of computerized med administration. This is possibly a pre-packaged medication might come as an anti-coagulant with an air lock in it. Which we would not remove and we may or may not need to put a needle on it, it just depends. But if we would put a needle on it, we would need to get the correct needle for a sub- cutaneous injection. So in this case, I have gotten a 25 gauge needle. Uhm 5/8 inch which is correct for sub q. So I have what I need. I have scanned it. I have checked it the three times. I am going to come in and administer it to my patient. I am going to give it in the abdomen because that is where we give anti-coagulants generally and I am going to use my landmarks that are indicated which is two inches or two finger widths around the umbilicus. I am going to look for a spot that isn’t bruised because sometimes we see that in patients getting anti-coagulants little bruise spots. So I am going to clean my area with my alcohol prep pad, let it dry for a little bit. Then, I am going to pull my cap of my needle straight off. I have a safety needle and I’ll engage this immediately after the injection. I am going to pinch up a little bit because this is a sub q injection. I am going to go in at ninety degrees holding my syringe like a dart. Always like a dart, you have a lot of control over it that way. I am going to insert the needle all the way. So, I have had my alcohol dry now. I am going to go in gently but quickly I am going to give the medication slowly. Then, I am going to wait a few seconds. I believe the book says 10 seconds then I am going to not massage or anything. You noticed I did not aspirate so I will come out and then engage my safety device on my needle right away and use my 2×2 for a little pressure, again not massaging. And we will make sure that there is no oozing or anything or bleeding before we leave and situate our patient. and make sure he is comfortable. Put our rails up. Lower the bed and all of those good things. Then, we can go to our computer if it is indicated, or your paper MAR whatever system you are working in and you might need to indicate the site that you used, you know we could have checked from before to see where it was given. Just, you know, be sure we give it in a clear spot. And then we have recorded our medication. We have electronically signed already

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