Unit 9 Intradermic injection（皮内注射)

Objectives and injection sites

1.  Hypersensitivitytest（药物过敏试验)------- inner aspect offorearm

2.  Vaccination（预防接种) ------- lateral and posterioraspects of upper arm

3.  Topicalanaesthesia(局部麻醉)

Equipment

Basic therapeutic tray(基础治疗盘)

Syringes (1ml and 5ml)

Needle (4 – 4¹/₂)

Adrenalin(肾上腺素)

Procedure

1. Take equipment to client’s room.

2. Identi国家医学考试网fy the client and medication. ask client to statename.

3. Explain action of medication and procedure ofadministration. History of anaphylaxis(过敏反应) must be know inside out.

4. Select site for injection and wash your hands. Cleanse areawith alcohol swab.

5. Check medication and client again.

6. Expel all air bubbles from syringe.

7. Gently pull the skin taut（紧)on ventral(腹侧的)forearm.

8. Insert needle at a 5^。 angle with the bevel（斜面) of the needle facing up.

9. After the whole bevel goes into skin, fix the syringefirmly.

10.   Inject 0.1ml medicationslowly. Observe for signs of wheal（皮丘) formation and blanching at the site.

11.   Withdraw needle. Do notmassage area.  

12.   Record time and disposeof equipment.

13.   Wash hands, and recheckagainst the client’s medication record.

14.   Tell client do not pressor scratch the area. If has any discomfort, tell nurse as soon as possible.

15.   15—20’ later, observe and record result.

Intravenous injection（静脉注射)

Objectives

1. To promote rapid absorption of the drug

2. When drug is irritating to tissues or can’t be taken orally.

Venipuncture sites

1. Inspect both of client's arms, palpating(触诊) and visualizing（观察) the course of the veins.

2. Vein should be superficial, easily palpated, and largeenough for needle insertion and advancement.

3. Area should be free of lesions or scars and away fromjoints.

4. Distal end of vein should be selected first, reserving moreproximal sites for future IV therapy.

1. Select larger veins for hypertonic（高渗) solutions, blood, and viscous （粘滞的)fluids.

2. Avoid using veins in affected arm following mastectomy（乳房切除术).

3. Lower extremity sites are associated with complications(e.g., thrombosis 血栓症)and should be used ONLY if necessary.

4. If possible, select a vein on client's nondominant（非优势的) arm.

venipunctureSites in common use

Dorsal Venous Network 手背静脉网

Dorsal Plexus   足背静脉丛

Dorsal Arch 足背静脉弓

Basilic Vein  贵要静脉

Dorsal Metacarpal Veins   掌骨静脉

Cephalic Vein  头静脉

Radial Vein  径脉

Median Cubital Vein     肘正中静脉

Ulnar Vein   肘脉

Greater Saphenous Vein    大隐静脉

u  Equipment

Basic therapeutic tray(基础治疗盘)

Syringes and needle

Tourniquet（止血带)

Protective pad（治疗巾)

u  Procedure

1. Take equipment to client’s room.

2. Identify the client and medication. Have client state name.

3. Explain the procedure to client.

4. Select site for injection and set the protective wrap underarm.

5. Wash your hands. Apply iodophor(碘伏) to selected venipuncture site and dry.

6. Apply tourniquet 6cmabove selected site to distend vein.

7. Check medication and client again. Ask client to closwww.med126.com/jianyan/e fist.

8. Expel all air bubbles from syringe.

9. With needle bevel up, enter client’s skin at a 20-25^。angle. Flatten angle once needle isunder skin and then enter vein.

10.   Observe for flashback ofblood.

11.   Carefully advance needleup course of the vein.

12.   Release tourniquet andfist.

13.   Inject medication slowly.Observe client’s situation.

14.   Withdraw needle, and quicklypress sterile swab over venipuncture site. Hold firmly until bleeding stops.

15.   Dispose of equipment.

16.  Wash hands, and recheck against the client’s medicationrecord.

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