Part 1 Principles and Routes of Medication Administration

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1 1 Chapter 7, Medication Administration Part 1 Principles and Routes of Medication Administration 2 Caution: Administering medications is business Always take appropriate Standard measures to reduce your risk of exposure during medication administration. Knowing all drug administration is essential. 3 Medical Asepsis It is important to keep the and all the equipment clean. free of all forms of life Medically clean involves careful handling to prevent contamination 4 Needle Handling Precautions Minimize the tasks performed in a ambulance. Immediately dispose of used sharps in a sharps. Avoid recapping needles. Avoid off sharps 5 Medication Administration and Documentation Record all information concerning the patient and medication including: for drug administration. and route delivered. Patient to the medication both positive and negative. 6 Transdermal Administration Absorbed through the skin at a slow, steady rate Method Standard Precautions administration site Apply medication Leave medication in place for required. Monitor the patient for desirable or adverse effects. 7 Mucous Membranes Absorbed through the membranes at a moderate to rapid rate 8 Sublingual Medication Administration Place the pill or direct spray between the of the tongue and the floor of the oral cavity. 1

2 9 Buccal Medication Administration Place the medication the patient s cheek and gum. 10 Eye Drop Administration Use a medication dropper to place the prescribed dosage on the sac. 11 Nasal Medication Administration Use to administer medication into a nostril 12 Aural Medication Administration Manually open the ear and administer the appropriate dose. 13 Pulmonary Drug Administration Medications are administered into the system via inhalation or injection. Small Volume Hand Held (HHN) Metered Dose Atomizer 14 Nebulizers 15 Oral Drug Administration Any medication taken by and swallowed into the GI tract. Be sure the patient has an adequate level of to prevent aspiration. 16 General Principles of Oral Administration (1 of 2) Use appropriate Standard measures. Note whether to administer medication with or on empty stomach. Gather any necessary. 17 General Principles of Oral Administration (2 of 2) Have patient sit when not contraindicated. Place the medication into your patient s mouth. Allow self-administration; assist when needed. Follow administration with - ounces of water and ensure that patient has swallowed the medication 18 Rectal Administration The rectum s extreme promotes rapid drug absorption. Medications do not travel through the and are not subject to hepatic alteration. 19 Catheter placement on needleless syringe 2

3 20 Syringe attached to endotracheal tube 21 Prepackaged enema container 22 Parenteral Drug Administration Drug administration outside of the tract 23 Syringes and Needles 1 Syringe 2 needle 24 Kinds of Parenteral Drug Containers Glass Single and vials Nonconstituted syringes syringes Intravenous medication fluids 25 Ampules and Vials 26 Information On Drug Labels Name of medication date Total dose and 27 Obtaining Medication from a Glass Ampule 28 Hold the ampule upright and its top to dislodge any trapped solution. 29 Place around the thin neck 30 and snap it off with your. 31 Draw up the medication. 32 Obtaining Medication From a Vial 33 Confirm the vial. 34 Prepare the syringe and hypodermic. 35 the vial s rubber top. 36 Insert the hypodermic needle into the rubber top and the air from the syringe into the vial. 37 Withdraw the appropriate of medication. 38 Insert a new hypodermic and 3

4 administer. 39 Non-Constituted Vials The non-constituted drug vial actually consists of vials, one containing a powdered medication and one containing a liquid mixing solution. Confirm on both Pull fluid from the fluid vial and inject into the 40 Key Points for Non-Constituted Vials both vial tops mixture after injecting liquid Change needles injecting Administer the medication 41 Mix-O-Vial System In the Mix-O-Vial system, the vials are joined at the. Confirm the labels. the vials together to break the seal. Agitate or to mix completely. Withdraw as normal 42 Prefilled or Preloaded Syringes (1 of 2) Confirm medication indications and patient Confirm prefilled syringe (name, dose, and expiration date) Assemble the prefilled syringe. Remove the pop-off caps and together 43 Prefilled or Preloaded Syringes (2 of 2) indication, drug, dose, and route of administration Administer appropriately via the indicated Properly of the needle and syringe 44 Subcutaneous Injections 45 Subcutaneous Injection Sites 46 the equipment. 47 SC Needles SC needles are normally or 1/2 in length Most are already attached to cc syringes Commonly called Insulin or terbuculin syringes 48 Check the medication. 49 Draw up the medication. Expel excess. 4

5 50 Prep the site. Clean and up skin. 51 Insert the needle at a angle. Release skin, aspirate for blood return and inject. 52 Subcutaneous Injection 53 Remove the needle and the puncture site. 54 the patient. 55 Epinephrine 1:1,000 heart rate and blood pressure and decreases muscle tone of bronchi Eases breathing problems in asthma or reactions Delivered by Auto-Injector or SC injection Adult Dosage is - mg Pediatric Dosage is mg/kg to a max of mg Dosages can vary according to protocols 56 Epinephrine 1:1,000 Usual concentration is 1mg/1cc Drawn up in cc syringe 0.1cc= mg EMT-Bs and EMT-Is can give by SC if properly trained in the SPEMS area 57 Contraindications to Epinephrine to Epinephrine shock insufficiency 58 S/S After Epinephrine 1 Signs Tachypnea Flushed skin Anxiety Vomiting 2 Symptoms Nausea Restlessness Heart palpitations 5

6 59 Intramuscular Injection Sites Dorsal Vastus lateralis Rectus femoris 60 Intramuscular Injection Sites 61 Intramuscular Injection 62 the equipment. 63 the medication. 64 up the medication. 65 the site. 66 Insert the needle at a angle. Aspirate for blood return and inject 67 the needle and cover the puncture site. 68 the patient. 69 Endotracheal Tube Several medications can be administered through an endotracheal tube: Atropine Epinephrine Drugs given via ETT should be in dosage No more than cc of fluid at one time 70 Conclusion ANY drug can be under the right circumstances Always check, check, and check Concentration date NO drug administration should ever be considered routine 6

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