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Friday, February 7, 2014

INJECTION PROCEDURE SOP ACTION GIVING INJECTION (INJECTION)

SOP INJECTION
PROCEDURE FOR ACTION GIVING INJECTION (INJECTION)

A. INJECTION INTRA VENA

 This injection is done by injecting a drug into a vein
 Intravenous injection given if required rapid drug reactions
 Injection angle 15o-30o then parallel to the vein
 Venous injection site must first be sought vein distal section and then the proximal

1. Preparation
 Tool
a. Syringe with needle no.22-25
b. Cotton alcohol
c. Drugs from ampoules or vials
d. Clean gloves
e. Note the treatment
f. Tourniquet
g. Bak injection
h. Crooked
i. Perlak

 Patient
a. Sapa patients with a friendly smile
b. Describe the action procedures

2. Work
1. Close the curtains or doors
2. Washing hands
3. Take medications as prescribed
4. Wear gloves
5. Position the patient comfortable and relaxed
6. Decide to be punctured vein (venous chefalika basilica and veins), venous condition:
unbranched and not puncture marks, hairless skin.
7. Replace perlak under the area to be injected
8. When the vein has been discovered (eg vena basilica) set the arms straight and the tide
tourniquet until the veins actually can be seen and touched
9. Prepare syringe which already contains the drug, if there is still air in the syringe, the
air must be removed
10. When the client is attached veinflon, clean the injection port which leads to the main
iv stream with an alcohol swab.
 11. Open iv port flow and open and insert the syringe needle syringe without a needle into
veinflon and inject the drug.
12. Stick a needle into the vein with the needle position at an angle parallel to the vein 15-
30
13. Aspirate by pulling on the syringe plunger. When the blood has been sucked release the
tourniquet and slowly push the drug into a vein
14. After the drug entered the vein, immediately pull the syringe, cotton swab with alcohol
with less pressing
15. Restore the patient in a comfortable position.
16. Cover and dispose of the syringe, ampoule / vial in place that has been provided
(medical waste sharps)
17. Observation of patient response to injection
18. Remove the gloves and wash hands
19. Document procedures (5T + 1W: Proper medication, right dose, right patient, right
time, right route of administration and alert)
20. Observation of drug side effects (redness, pain and heat)

3. Termination
a. Give praise to the client
b. Say thanks

B. INJECTION INTRA Muscular

 The injection is performed by injecting the drug in muscle tissue
 Vascularization in the muscles better than subcutan so that absorption in muscle tissue will be
faster. Absorption liquid medicine on IM will occur approximately 10-30 minutes, whereas in the SC
can reach up to 30 minutes.
 The needles used are numbers 21-23, while for thin clients use a smaller needle size and short.
 Injection angle of 90o to pass through a layer of the SC to get into the muscle layer
 IM injections are more tolerant to a total volume of more than in SC so that it can be injected
drug 4 cc or more
 If you give a drug that can irritate, use Z-track technique when injecting ie by menghisapkan
0.5 ml of air into the syringe to form a blockage of air. Pull underneath the skin and subcutaneous
tissue 2.5 cm-3.5 cm laterally to the side. Hold the back skin and injection needle quickly.

1. Preparation
 Tool
a. Syringe with needle no.22-25
b. Needle diameters of 20-30
c. Cotton alcohol
d. Drugs from ampoules or vials (0.5 mL)
e. Clean gloves
f. Note the treatment
g. Bak injection
h. Crooked
i. Perlak
 Patient
a. Sapa patients with a friendly smile
b. Describe the action procedures

2. Work
1. Close the curtains or doors
 2. Washing hands
3. Take medications as prescribed
4. Wear gloves
5. Assess Area injections: no lesions, there is no infection, there are herniated discs,
there are no nerves and blood vessels
6. Position the patient comfortable and relaxed adjusted by injecting the area to be used:
o Ventro gluteal: the prone position or tilted with knee flexion
o Vastus lateralis: flat position, supine with the knee slightly flexed
o Dorso gluteal: a prone position with the knee flexed
o Deltoid: sitting or lying position with arms flexed, relax or placed over the abdomen
7. Replace perlak under the area to be injected
8. Make a Z-track with the non-dominant hand
9. Clean the injection site with an alcohol swab by rubbing in circular directions out about
5 cm
10. Put the alcohol swab on the non-dominant hand. Open the lid of the syringe and hold
the syringe in the dominant hand (between thumb and forefinger)
11. Inject the needle at an angle of 90 ° (vastus latralis the needle enters with a depth of
1.5-2.5 cm; ventro gluteal needle entry with depth: 1,25- 2,5 cm; dorso gluteal needle
entry with depth: 1.25 to 3 , 75 cm; deltoid needle entry with depth: 1.25 to 2.5 cm)
12. Once the needle goes into the muscle, move the non-dominant hand down the syringe
(to fix that does not move the needle position) and the dominant hand is moved to the
pengokang syringe to aspirate ready
13. Aspiration syringe to make sure the needle does not pierce the blood vessel, if there
are no blood injected the drug at a rate of 10 seconds / mL. If there is blood immediately
unplug the syringe and replace on the other injection position
14. Pull the syringe, cotton swab with alcohol with less pressing
15. Restore the patient in a comfortable position.
16. Cover and dispose of the syringe, ampoule / vial in place that has been provided
(medical waste sharps)
17. Observation of patient response to injection
18. Remove the glove enter into a solution of chlorine and wash hands
19. Document procedures (5T + 1W: Proper medication, right dose, right patient, right
time, right route of administration and alert)
20. Observation of drug side effects (redness, pain and heat)

3. Termination
a. Give praise for the cooperation client
b. Say thank you

C. INJECTION SUB CUTAN

 The injection is performed by injecting the drug in the tissue under the skin
 In sub cutan there is less blood circulation so that the drug will be absorbed slowly (not secspat
if given IM)
 Drugs administered SC usually isotonic, noniritatif, water soluble, and can be tolerated up to
0.5-1 cc
 Examples of drugs administered SC are: insulin, TT (tetanus toxoid), epinephrine, allergy
medications, and heparin (can be absorbed well by the SC and IM)
 SC injection site: deltoid, abdomen, thighs, scapula area, the ventral gluteal
  Injection site lesions should not be there, there is no infection, not on a protrusion of bone and
tissue underneath there are nerves and blood vessels
 Injection angle 45o. For clients who are obese can be at an angle of 90o. In the thin client
should be in the upper abdomen

1. Preparation
 Tool
a. Syringe with needle no.22-25
b. Cotton alcohol
c. Drugs from ampoules or vials (0.5 mL)
d. Clean gloves
e. Note the treatment
f. Bak injection
g. Crooked
h. Perlak
 Patient
 Sapa patients with a friendly smile
 Describe the action procedures

2. KerjaTutup curtain or door

1. Washing hands
2. Take medications as prescribed
3. Select the injection site: deltoid, abdominal somewhere that no lesions, there is no
infection, there are herniated discs, there are no nerves and blood vessels
4. Position the patient comfortable and relaxed
5. Replace perlak under the area to be injected
6. Wear gloves
7. Clean the injection site with an alcohol swab by rubbing in circular directions out about
5 cm or swab one direction proximal to distal
8. Put the alcohol swab on the non-dominant hand. Open the lid of the syringe and hold
the syringe in the dominant hand (between thumb and forefinger)
9. With the non-dominant hand pinch deltoid area
10. Inject the drug at an angle of 45-90 °
11. Aspiration syringe to make sure the needle does not pierce the blood vessel, if there
are no blood injected the drug. If there is blood immediately unplug the syringe and replace
on the other injection position
12. Pull the syringe, cotton swab with alcohol with less pressing
13. Restore the patient in a comfortable position
14. Cover and dispose of the syringe, ampoule / vial in place that has been provided
(medical waste sharps)
15. Observation of patient response to injection
16. Remove the gloves and wash hands
17. Document procedures (5T + 1W: Proper medication, right dose, right patient, right
time, right route of administration and alert)
18. Observation of drug side effects (redness, pain and heat)

3. Termination
 Give praise to the client for their cooperation
 Say thank you
D. INJECTION intradermal / INTRA CUTAN
  This injection is done by injecting the drug under the skin surface of the inner antebrachii
 Used for tuberculin skin test or tests
 Intradermal have minimal blood circulation and drug medication will be absorbed slowly (very
slowly). Beneficial to skin tests because some clients will experience anaphylactic reactions if the
drug into the body quickly
 Using a small gauge needle (1 / 4-1 / 2 inches) or a special needle tuberculin test
 Injection angle 5-15o
 Injection site: skin surface is bright, a little hair, no lesions and edema
 The amount of fluid injected 0.01-0.1 cc
Example: 1 gram of ampicillin diluted 5 cc of distilled water. Take the solution is then diluted
himgga 0.1 cc 1 cc. ADD medication intradermally / intracutan 0.01-0.1 cc

1. Preparation

 Tool
 Syringe with needle no.22-25
 An alcohol swab
 Drugs from ampoules or vials (for age <1 year: 0.05mL, for age> 1 year: by 0.10 mL)
 Clean gloves
 Note treatment
 pencil skin
 Bak injection
 Crooked
 Perlak

 patient
 Sapa patients with a friendly smile
 Describe the action procedures

2. Work
1. Close the curtains or doors
2. Washing hands
3. Take medications as prescribed
4. Select the injection site (skin surface is bright, a little hair, no lesions or edema) 3-4
fingers below the ante-cubital
5. Position the patient comfortable with elbow extension and put the arm on a flat
surface
6. Wear gloves
7. Clean the injection site with an alcohol swab by rubbing in circular directions out about
5 cm or swab one direction proximal to distal
8. Put the alcohol swab on the non-dominant hand. Open the lid of the syringe and hold
the syringe in the dominant hand (between thumb and forefinger)
9. With the non-dominant hand stretch the skin surface
10. Inject the drug at an angle of 5-15 °, ± 3 mm needle entry. The entry of the needle can
be seen from the surface of the skin
 11. The exact result is there are undulations on injection site
12. Pull the syringe, cotton swab with alcohol but must not be pressed
13. Restore the patient in a comfortable position, give marks on the skin using a
pencil. Advise clients to wash the injection site
14. Cover and dispose of the syringe, ampoule / vial in place that has been provided
(medical waste sharps)
15. Remove the gloves and grandchildren hand
16. Evaluation: positive test results if there is redness, swelling.
17. Document procedures (5T + 1W: Proper medication, right dose, right patient, right
time, right route of administration and alert)
18. Observation of drug side effects (redness, pain and heat)

3. Termination
 Give praise to the client for their cooperation
 Say thank you
Posted by Riswan ajha at 14:29
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