SYRINGES AND NEEDLES
MEDICINE are administered as injections using a needle and a syringe. A syringe consists of a barrel and a plunger (piston). A type of syringe known as Luer-Lock syringe has the advantage that the needle can be locked in position. Intravenous injections are given with the help of an infusion set.
Sizes: Syringes are available in various sizes 1,2,5,10,20 and 50 ml. Syringes may be of two materials- Glass and Plastic.
Glass Syringes
Advantages:
1.The markings are accurate and therefore, exact quantity can be drawn.
2.The fluid level can be clearly seen as the glass is transparent.
3.They can be easily sterilized by boiling and reused.
4.Glass syringes are resistant to punctures.
Disadvantages:
1.Glass syringes can break.
2.They carry a greater risk of air embolism because they are rigid.
3.They are more expensive. Glass syringes are no more preferred because of the risk of spreading dangerous diseases like AIDS when not properly sterilized.
Plastic Syringes
Advantages:
1.Plastic syringes do not break easily.
2.Because they are collapsible, they allow proper emptying of the syringe-hence less risk of air embolism.
3.They are cheaper.
4.They are disposable.
Disadvantages:
1.Plastic syringes are not very accurate in scale.
2.They cannot be easily sterilized.
3.They cannot be reused.
Special Syringes
Insulin syringe has markings in units (40 in 1ml (red) or 80 in 1 ml (green) are suitable for administration of insulin.
Tuberculin syringe is a syringe of 1 ml. Capacity with 0.01 ml markings. It is useful for administration of very small volumes.
Injections:
Injections are parenteral therapy. It means giving of therapeutic agents including food outside the alimentary tract.
An injection is the forcing of a fluid into a cavity, a blood vessel or body tissue through a hollow tube or needle.
Types of Injections
1.Intradermal- Drug introduced into the dermis.
2.Subcutaneous- Drug introduced into the subcutaneous tissue.
3.Intramuscular-Injected into the muscles.
4.Intravenous-Introduced into the vein.
5.Intraspinal-Introduced into the spinal cavity.
6.Intraosseous-Introduced into the peritoneal cavity.
7.Venesection-Opening a vein and introducing a tube or wide bore needle and introducing medicines and fluids or taking out blood.
8.Infusions- When a large quantity of medicines is fluids are to be introduced into the body.
9.Transfusions-
It is the introduction of whole blood or plasma into a vein or artery.
Factors that Favors Absorption:
1.Blood supply to the area-Fluids injected into the blood stream will act quicker that any other methods used.
2.The composition of the fluid injected-Solubility and diffusibility of the fluid.
3.Aplication of heat-Heat dilates the blood vessels; therefore, the heat applied over the site of injection increases the rate of absorption.
4.Massage- It stimulates the local blood supply and increases the rate of absorption.
5.Circulation time of the blood-Absorption of medicines and fluids injected into the body will diminished in a person who has venous congestion (edema).
6.Physical condition-The local disease condition of the skin and underlying tissues such as skin lesions, inflammations, etc. delays the absorption of the drug.
7.Addition of the substances- That tends to breakdown the natural resistance of the tissues can increase the rate of absorption.
Criteria for selection of Syringes and Needles
1.Intradermal: Tuberculin syringe or 1 ml calibrated in 0.01 ml units. 26 or 27 gauge diameter and 3/8 to 5/8 length size of needle used.
2.Subcutaneous: Insulin syringe or 1 ml calibrated in 40 or 80 units syringe, 25 gauge and 1/2 to 5/8 inches syringe is used.
3.Intramuscular: 2.5 ml syringe is used it calibrated in 0.2 ml. 21,22,23 gauge 1 to 2 inches in length needles are used.
4.Intravenous: The size depends upon the amount of fluids to be injected, 18 to 20 gauge 1 to 2 inches needles use.
INTRA-MUSCULAR INJECTION
Intramuscular injection is defined as introduction of medicine into the muscle in form of solution
Purpose
1.To obtain a quick effect of medicine than is obtained by oral administration and subcutaneous administration.
2.Assures that the total dosage will be administered and the same will be absorbed for the systemic action of the drug.
3.The medicines that is not suitable for intravenous administration.
Site of Intramuscular Injections
Dorsal gluteal site- Find out the greater trochanter of the femur and the posterior superior iliac spine drawn an imaginary line between these two bony prominence. Site will be upper and outer quadrant.
Vastus lateralis site- The site is at the outer aspect of the thigh. It is the area between mid anterior thigh and mid lateral thigh one hands span from elbow and great trochanter to one hands span above knee.
Ventrogluteal site- Place the tip of the index finger on the anterior superior iliac spine of the patient the middle finger just below the iliac creast.
Mid deltoid site- Locate the lower edge of the acromion process and form a rectangle. The deltoid area is used to inject very small quantities of nonirritating drugs.
Z-tract method_ Expel the air from the syringe, displace the skin laterally using the side of your left hand, insert the needle aspirate the placement, inject the medicine very slowly, marinating tissue displacement wait for ten seconds to allow the medicine to disperse. Withdraw the needle allowing the displaced issue to return to its normal position.
Subcutaneous Injection
Subcutaneous injection involves placing medication into the loose connective tissue under the dermis.
Subcutaneous injection means the introduction of medicine into the subcutaneous tissues. Drug is injected into the layer of fatty issues beneath the upper layers of the skin.
Purpose
1.To administer the medication that is ineffective in the gastrointestinal tract by the action of the digestive juice.
2.To administer smaller doses.
3.For slow drug absorption.
4.To obtain a prompt action of a medicine that is obtained by oral administration.
General Instructions
1.A 90 degree angle is normally used with a 5/8 inch needle is used with a 5/8 inch needle for obese patients.
2.A 45 degree angle is used with a needle ¾ inch long or longer for an average patients are in a thin patient.
3.The techniques of giving injection for hypodermic injections will be same as in IM injection.
4.Use only nonirritating medications.
5.Use only small quantity of medication.
6.Deposit the medication in a fold formed by picking up a layer of skin and fat.
7.Be sure to insert the needle beyond the thickness of the skin (the medications is to be deposited in the subcutaneous tissue).
Intradermal Injections
An Intradermal injection is the introduction of a hypodermic needle into the dermis. Intradermal medicine when introduced into the dermis (under the epidermis).
Purpose
1.To obtain a local effect at the site of injection of local anesthesia such as xylocaine and novocaine.
2.Diagnostic purpose as in sick test, tuberculin test, etc.
3.To test for allergic reaction to a drug, e.g. penicillin serum, etc.
Selection of Syringe and Needle
1.Size of syringe used for Intradermal injections are 1 ml calibrated in 0.01 ml units (tuberculin syringe).
2.Size of needle used for Intradermal injections are 26 to 27 gauge diameter and 3/8 to 5/8 inch length.
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