ADMINISTRATION OF PARENTERAL

MEDICATIONS
DEFINITION : Is the administration of medication by injection.

Vial

Is a small glass bottle with a sealed rubber cap. Vials come in

different sizes from single to multi dose vials. They usually have a
metal or plastic cap that protects the rubber seal.

Ampoule

Is a glass container usually designed to hold a single dose of a

drug. It has a distinctive shape with a constrictive neck. Ampoule
varies in size ranging from 1-10ml or more. Most ampoule necks
has colored marks around it indicating where they are prescored
for easy opening.

Syringe

Consist of a cylindrical barrel with a tip designed to fit the hub

of a needle and a closed fitted plunger.

TYPES OF SYRINGE

Tuberculin Syringe Insulin Syringe

Marked in 0.01 Marked in units 100

Used for ID injection Used only for insulin

injection

For doses less than 1ml As prescribed

Standard syringe : Used most frequently for SC / IM. Marked in cubic

centimeter milliliters (ml).

Needle

It come package in individual sheaths to allow flexibility in

choosing right needle for a client.
Needle has 3 parts:
 i. The hub – which fits onto the tip of a syringe.
ii. The shaft – which connects to the hub.
iii. The bevel – slanted tip.

SELECTION OF SYRINGE AND NEEDLE

ROUTE VOLUME GAUGE

Intradermal 0.01-0.1 ml 26-29 G

Subcutenous 0,5-2 ml 25-27 G

Intramuscular 0.5-2 ml 20-22 G

Intravenous 1-2000 ml 20-22 G (solution)

15-19 G (blood)

WITHDRAWING MEDICATION FROM AMPOULE

AIM : To administer injection.

ARTICLES NEEDED

• MAR.
• Medication in an ampoule or vial.
• Syringe, needle (2).
• Small gauze piece.
• Antiseptic swab.
• File.
• Kidney tray.

PROCEDURE

1. Check client’s name and medication order, including medication

name, dose, route and duration of administration, signature of
doctor and special instructions. To prevent medication error.
2. Perform hand washing and assemble equipment. Reduces
transmission of microorganism.
3. Check label on ampoule against MAR for name, dosage, expiry
date, characteristic of drug. To ensure correct medication, dose
and potency (1st check).
4. Calculate dosage.
5. Check label on the ampoule to ensure right drug (2nd check).
6. Tap ampoule lightly and quickly with finger until fluid moves from
neck into ampoule. Drains any fluid that collects above neck of
ampoule into lower chamber.
7. Clean around neck of ampoule with alcohol swab to reduce risk of
infection.
8. Clean file with alcohol swab.
9. Place small piece of sterile gauze around the neck of ampoule. To
break neck of ampoule easily.
10. Break neck of ampoule quickly and firmly using sterile gauze to
protect finger from injury.
11. Steady ampoule with one hand and insert needle of syringe with
another hand. To withdraw medication without contamination.
Ensure the needle does not touch the rim of the ampoule.
12.Aspirate medication into syringe by pulling back of plunger.
13.Expel air bubbles :
i. Hold syringe with needle pointing up.
ii. Draw back slightly on plunger.
iii. Push plunger upward to eject air.
1. Check drug in the syringe to ensure right amount of medication.
2. Check label on ampoule against MAR (3rd check).
3. Recap needle with one hand.
4. Bring syringe, ampoule and swab in the tray to the client.
5. Administer medication to client.
6. Dispose all used equipments and clean the tray / trolley.
 WITHDRAW MEDICATION FROM VIAL
AIM : To administer injection.

ARTICLES

• MAR.
• Medication in ampoule or vial.
• Syringe, needle (2).
• Small gauze piece.
• Antiseptic swab.
• File.
• Kidney dish.

PROCEDURE

1. Check client’s name and medication order, including medication

name, dose, route and duration of administration, signature of
doctor and special instructions. To prevent medication error.
2. Perform hand washing and assemble equipments. Reduces
transmission of microorganism.
3. Check label on vial against MAR for name, dosage, expiry date,
characteristics of drug. To ensure correct medication, dose and
potency (1st check).
4. Calculate dosage.
5. Check label on the vial to ensure right drug (2nd check).
6. Remove cap covering the rubber seal of the vial. Each cap comes
with a safety cap, once removed it cannot be replaced.
7. Firmly and briskly wipe surface of rubber seal with alcohol swab
in a circular motion and allow it to dry to reduce infection.
8. Assemble syringe and needle :
i. Remove cap from needle.
 ii. Pull back plunger to draw the amount of air which is
equivalent to volume of medication required. To build up
negative pressure.

1. Place vial on flat surface :

i. Insert needle through rubber seal at the centre part. Centre
part is thinner than other parts.
ii. Inject air into vial air space by pushing on plunger to create
positive pressure and to prevent formation of air bubbles.
1. Support vial between thumb and index finger of non dominant
hand. Thumb and 2 other fingers of dominant hand support the
syringe.
2. Invert vial and syringe as support in the dominant hand. To allow
fluid to settle in lower half of vial.
3. Keep tip of needle below fluid level to prevent of aspiration of air.
4. Allow air pressure from vial to fill syringe with medication positive
pressure within vial forces medication into syringe.
5. Remove needle from vial by pulling back on barrel.
6. For multiple – dose vial, label date of opening and sign to ensure
subsequent dose is prepared correctly.
7. Change needle before giving medication to patient. The needle
inserted into the vial is blunt.
8. Check label on vial and on MAR to ensure right drug (3rd check).
9. Bring the syringe, vial and swab in a tray to the patient.
10.Administer medication to the patient.
11.Dispose all used equipment and clean the tray / trolley.
 VIAL CONTAINING POWER MEDICATIONS
REQUIREMENT

As for WITHDRAWING MEDICATION FROM VIAL include

diluents.
– Normal saline / Water for injection.

PROCEDURE

Follow step 1-7 as per withdrawal of medication from vial.

i. Remove cap covering powered medication.

ii. Fill syringe with required amount of diluents.
iii. Insert needle through centre part of rubber seal of vial.
iv. Inject diluents into vial to ensure diluents begins to dissolve
medication.
v. Remove needle.
vi. Roll vial between palms.
vii.Mix medication thoroughly to ensure proper reconstitution of
medication.
viii.Reconstituted medication us ready to be withdrawn.
ix. Change needle before administering medicine to client.