Division 1 Introduction to Advanced Prehospital Care

Transcription

1 Division 1 Introduction to Advanced Prehospital Care Chapter 7 Intravenous Access and Medication Administration Part 1 Principles and Routes of Medication Administration Topics Aseptic Technique Medication Administration Routes Medication Package Anatomy and Physiology Related to Medication Administration 1

2 Six Rights of Drug Administration Right person Right drug Right dose Right time Right route Right documentation Knowing all drug administration protocols is essential. Always take appropriate Standard Precautions measures to reduce your risk of exposure during medication administration. 2

3 Standard Precautions equipment Medical Asepsis It is important to keep the ambulance and all the equipment clean. Sterile Free of all forms of life Medically clean Involves careful handling to prevent contamination Treat all blood and body fluids as potentially infectious. 3

4 Needle Handling Precautions Minimize the tasks performed in a moving ambulance. Immediately dispose of used sharps in a sharps container. Use needless system when possible Recap needles only as a last resort. Medication Administration and Documentation Record all information concerning the patient and medication including: Indication for drug administration Dosage and route delivered Patient response to the medication Both positive and negative Percutaneous drug administration is drugs applied to and absorbed through the skin or mucous membranes. 4

5 Transdermal Absorbed through the skin at a slow, steady rate Method Standard Precautions Clean administration site Apply medication Leave medication in place for required time. Monitor the patient for desirable or adverse effects. Mucous Membranes Absorbed through the mucous membranes at a moderate to rapid rate Sublingual Medication Administration Place the pill or direct spray between the underside of the tongue and the floor of the oral cavity. 5

6 Buccal Medication Administration Place the medication between the patient s cheek and gum. Eye Drop Administration Use a medication dropper to place the prescribed dosage on the conjunctival sac. Nasal Medication Administration 6

7 Intranasal Aural Medication Administration Manually open the ear canal and administer the appropriate dose. Pulmonary Drug Administration Medications are administered into the pulmonary system via inhalation or injection. 7

8 Small volume nebulizer Nebulizer with attached face mask, bag-valve mask, and endotracheal tube Metered dose inhaler 8

9 Enteral Drug Administration The delivery of any medication that is absorbed through the gastrointestinal tract Gastrointestinal tract Oral Drug Administration Any medication taken by mouth and swallowed into the GI tract. Be sure the patient has an adequate level of consciousness to prevent aspiration. 9

10 Oral Drug Forms Capsules Tablets Pills Enteric-coated/ time-release capsules and tablets Elixirs Emulsions Lozenges Suspensions Syrups Equipment for Oral Administration Soufflé cup Medicine cup Medicine dropper Teaspoon Oral syringe Nipple General Principles of Oral Administration Use appropriate Standard Precautions measures. Note whether to administer medication with food or on empty stomach. Gather any necessary equipment. Have patient sit upright when not contraindicated. Place the medication into your patient s mouth. Allow self-administration; assist when needed. Follow administration with 4-8 ounces of water and ensure that patient has swallowed the medication. 10

11 Gastric Tube Administration Gastric tubes provide access directly to the GI system. Confirm proper tube placement. Withdraw the plunger while observing for the presence of gastric fluid or contents. 11

12 Instill the medication into the gastric tube. Gently inject the saline. Clamp off the distal tube. 12

13 Rectal Administration The rectum s extreme vascularity promotes rapid drug absorption. Medications do not travel through the liver and are not subject to hepatic alteration. Catheter placement on needleless syringe Syringe attached to endotracheal tube 13

14 Prepackaged enema container Parenteral Drug Administration Drug administration outside of the gastrointestinal tract 14

15 Syringes and Needles Syringe Hypodermic needle Kinds of Parenteral Drug Containers Glass ampules Single and multidose vials Nonconstituted syringes Prefilled syringes Intravenous medication fluids Ampules and Vials Ampules Vials 15

16 Information on Drug Labels Name of medication Expiration date Total dose and concentration Obtaining Medication from a Glass Ampule Hold the ampule upright and tap its top to dislodge any trapped solution. 16

17 Place gauze around the thin neck and snap it off with your thumb. Draw up the medication. 17

18 Obtaining Medication from a Vial Confirm the vial label. Prepare the syringe and hypodermic needle. 18

19 Cleanse the vial s rubber top. Insert the hypodermic needle into the rubber top and inject the air from the syringe into the vial. The nonconstituted drug vial actually consists of two vials, one containing a powdered medication and one containing a liquid mixing solution. 19

20 Nonconstituted drugs come in separate vials. Confirm the labels. Remove all solution from the vial containing the mixing solution. Cleanse the top of the vial containing the powdered drug and inject the solution. 20

21 Agitate or shake the vial to ensure complete mixture. Prepare a new syringe and hypodermic needle. Withdraw the appropriate volume of medication. 21

22 In the Mix-O-Vial system, the vials are joined at the neck. Confirm the labels. Squeeze the vials together to break the seal. Agitate or shake to mix completely. Withdraw the appropriate volume of medication. 22

23 Prefilled or Preloaded Syringes Confirm medication indications and patient allergies. Confirm prefilled syringe label (name, dose, and expiration date). Assemble the prefilled syringe. Remove the pop-off caps and screw together. Reconfirm indication, drug, dose, and route of administration. Administer appropriately via the indicated route. Properly dispose of the needle and syringe. Parenteral Routes Intradermal injection Subcutaneous injection Intramuscular injection Intravenous access Intraosseous infusion Intradermal Injection 23

24 Assemble and prepare the needed equipment. Check the medication. Draw up the medication. 24

25 Prepare the administration site. Pull the patient s skin taut. Insert the needle, bevel up at a 10-15º angle. 25

26 Remove the needle and cover the puncture site with an adhesive bandage. Monitor the patient. Subcutaneous Injection 45º 26

27 Subcutaneous Injection Sites Prepare the equipment. Scott Metcalfe Check the medication. Scott Metcalfe 27

28 Draw up the medication. Scott Metcalfe Prep the site. Scott Metcalfe Insert the needle at a 45º angle. Scott Metcalfe 28

29 Remove the needle and cover the puncture site. Scott Metcalfe Monitor the patient. Scott Metcalfe Intramuscular Injection Sites Deltoid Dorsal gluteal Vastus lateralis Rectus femoris 29

30 Intramuscular Injection 90º Intramuscular Injection Sites Prepare the equipment. Scott Metcalfe 30

31 Check the medication. Scott Metcalfe Draw up the medication. Scott Metcalfe Prepare the site. Scott Metcalfe 31

32 Insert the needle at a 90º angle. Scott Metcalfe Remove the needle and cover the puncture site. Scott Metcalfe Monitor the patient. Scott Metcalfe 32

33 Summary Aseptic Technique Medication Administration Routes Medication Package Anatomy and Physiology related to Medication Administration 33