Medication Routes

1. Medication Routes 6 4a

2. Routes • Parenteral administration of medications is typically done through: • Subcutaneous • Intramuscular • Intravenous • Endotracheal • Intraosseous • Inhalation

3. Subcutaneous

4. Subcutaneous • Prepare equipment • Syringe • Needle • Alcohol swab • 4 X 4 gauze • Medication • Explain procedure • Confirm allergies • Examine medication, confirm that it is the desired med, expiry date, cloudy/discolored? • “Shake down” the ampule • Break top off ampule using 4 X 4 gauze • Draw medication into syringe and expel excess air

5. Subcutaneous • Choose suitable site • Pinch up the skin • Insert needle at a 45º angle • Aspirate the syringe to confirm placement • If blood is aspirated, withdraw needle and start over • Inject medication slowly • Remove syringe and dispose of Sharps • Apply pressure over site • Observe patient for effects • Document

6. Intramuscular • Prepare equipment • Syringe • Needle • Alcohol swab • 4 X 4 gauze • Medication • Explain procedure • Confirm allergies • Examine medication, confirm that it is the desired med, expiry date, cloudy/discolored? • “Shake down” the ampule • Break top off ampule using 4 X 4 gauze • Draw medication into syringe and expel excess air

7. Intramuscular • Choose suitable site • Hold skin tight • Insert needle at a 90º angle • Aspirate the syringe to confirm placement • If blood is aspirated, withdraw needle and start over • Inject medication slowly • Remove syringe and dispose of Sharps • Apply pressure over site • Observe patient for effects • Document

8. Intravenous Bolus • Prepare equipment • Syringe • Needle • Alcohol prep • Medication • Explain procedure • Confirm allergies • Examine medication, confirm that it is the desired med, expiry date, cloudy/discolored? • Load medication • Select appropriate IV port (closest to cannulation site) • Clean port with alcohol prep

9. Intravenous Bolus • Insert needle into port • Pinch off IV tubing proximal to port • Administer medication as required (Bolus, Slow IVP…) • Release IV tubing • Remove needle • Monitor patient for effect • Document

10. Intravenous “Piggyback” • Prepare Equipment • Medication • IV solution • Extra tubing • Needle • Label • Medication • Explain procedure • Confirm allergies

11. Intravenous “Piggyback” • Prepare medication in IV solution as required • Label medication and [ ] of drug • Attach needle to tubing and insert into patient’s IV port • Tape connection to IV line for security • Begin administration • May need to place bag higher then the IV bag to allow gravity to work • Observe patient for desired effect • Document

12. Endotracheal • Prepare equipment • Hyperventilate the patient • Remove BVM for ETT • Inject medication directly into ETT • Flush if Required • Replace BVM and ventilate • Monitor patient for desired effect

13. Intraosseous • Follow same procedures as IV administration