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Injections: Subcutaneous and Intramuscular

Clinical Indications:

    When medication administration is necessary and the medication must be given via the SQ (not auto-injector) or IM route or as an alternative route in selected medications.

Procedure:

    1. Receive and confirm medication order or perform according to standing orders.

    2. Prepare equipment and medication expelling air from the syringe.

    3. Explain the procedure to the patient and reconfirm patient allergies.

    4. The most common site for subcutaneous injection is the arm.
    Injection volume should not exceed 1 cc.

    5. The possible injection sites for intramuscular injections include the arm, buttock and thigh.
    Injection volume should not exceed 1 cc for the arm
    Injection volume should not exceed 2 cc in the thigh or buttock.

    6. The thigh should be used for injections in pediatric patients and injection volume should not exceed 1 cc.

    7. Expose the selected area and cleanse the injection site with alcohol.

    8. Insert the needle into the skin with a smooth, steady motion
    SQ: 45-degree angle IM: 90-degree angle skin pinched skin flattened

    9. Aspirate for blood

    10. Inject the medication.

    11. Withdraw the needle quickly and dispose of properly without recapping.

    12. Apply pressure to the site.

    13. Monitor the patient for the desired therapeutic effects as well as any possible side effects.

    14. Document the medication, dose, route, and time on/with the patient care report (PCR).

Competency Based Skill Requirements:

    Maintain knowledge of the indications, contraindications, technique, and possible complications of the procedure.

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