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Chapter 7 Intravenous Access and Medication AdministrationPart 1Principles and Routes of Medication Administration : 

1/95 Chapter 7 Intravenous Access and Medication AdministrationPart 1Principles and Routes of Medication Administration Galveston College EMS Paramedic 2009

Topics : 

2/95 Topics Aseptic Technique Medication Administration Routes Medication Package Anatomy and Physiology Related to Medication Administration

Six Rights of Drug Administration : 

3/95 Six Rights of Drug Administration Right person Right drug Right dose Right time Right route Right documentation

Slide 4: 

4/95 Knowing all drug administration protocols is essential.

Slide 5: 

5/95 Always take appropriate body substance isolation measures to reduce your risk of exposure during medication administration.

Slide 6: 

6/95 Body substance isolation equipment

Medical Asepsis : 

7/95 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 preventcontamination

Slide 8: 

8/95 Treat all blood and body fluids as potentially infectious.

Needle Handling Precautions : 

9/95 Needle Handling Precautions Minimize the tasks performed in a moving ambulance. Immediately dispose of used sharps in a sharps container. Recap needles only as a last resort.

Medication Administration and Documentation : 

10/95 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

Slide 11: 

11/95 Percutaneous drug administration is drugs applied to and absorbed through the skin or mucous membranes.

Transdermal : 

12/95 Transdermal Absorbed through the skin at a slow, steady rate Method: BSI Clean administration site Apply medication Leave medication in place for required time. Monitor the patient for desirable or adverse effects.

Mucous Membranes : 

13/95 Mucous Membranes Absorbed through the mucous membranes at a moderate to rapid rate

Place the pill or direct spray between the underside of the tongue and the floor of the oral cavity. : 

14/95 Place the pill or direct spray between the underside of the tongue and the floor of the oral cavity. Sublingual Medication Administration

Place the medication between the patient’s cheek and gum. : 

15/95 Place the medication between the patient’s cheek and gum. Buccal Medication Administration

Use a medication dropper to place the prescribed dosage on the conjunctival sac. : 

16/95 Use a medication dropper to place the prescribed dosage on the conjunctival sac. Eye Drop Administration

Nasal Medication Administration : 

17/95 Nasal Medication Administration

Manually open the ear canal and administer the appropriate dose. : 

18/95 Manually open the ear canal and administer the appropriate dose. Aural Medication Administration

Pulmonary Drug Administration : 

19/95 Pulmonary Drug Administration Medications are administered into the pulmonary system via inhalation or injection.

Small volume nebulizer : 

20/95 Small volume nebulizer

Nebulizer with attached face mask, bag-valve mask, and endotracheal tube : 

21/95 Nebulizer with attached face mask, bag-valve mask, and endotracheal tube

Metered dose inhaler : 

22/95 Metered dose inhaler

Endotracheal Tube : 

23/95 Endotracheal Tube Several medications can be administered through an endotracheal tube: Lidocaine Epinephrine Atropine Naloxone

Enteral Drug Administration : 

24/95 Enteral Drug Administration The delivery of any medication that is absorbed through the gastrointestinal tract

Gastrointestinal tract : 

25/95 Gastrointestinal tract

Oral Drug Administration : 

26/95 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.

Oral Drug Forms : 

27/95 Oral Drug Forms Capsules Tablets Pills Enteric coated/time releasecapsules andtablets Elixirs Emulsions Lozenges Suspensions Syrups

Equipment forOral Administration : 

28/95 Equipment forOral Administration Soufflé cup Medicine cup Medicine dropper Teaspoon Oral syringe Nipple

General Principles of Oral Administration : 

29/95 General Principles of Oral Administration Use appropriate BSI 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.

Gastric Tube Administration : 

30/95 Gastric Tube Administration Gastric tubes provide access directly to the GI system.

Confirm proper tube placement. : 

31/95 Confirm proper tube placement.

Withdraw the plunger while observing for the presence of gastric fluid or contents. : 

32/95 Withdraw the plunger while observing for the presence of gastric fluid or contents.

Instill the medication into the gastric tube. : 

33/95 Instill the medication into the gastric tube.

Gently inject the saline. : 

34/95 Gently inject the saline.

Clamp off the distal tube. : 

35/95 Clamp off the distal tube.

Rectal Administration : 

36/95 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 : 

37/95 Catheter placement on needleless syringe

Syringe attached to endotracheal tube : 

38/95 Syringe attached to endotracheal tube

Prepackaged enema container : 

39/95 Prepackaged enema container

Parenteral Drug Administration : 

40/95 Parenteral Drug Administration Drug administration outside of the gastrointestinal tract

Syringes and Needles : 

41/95 Syringes and Needles Syringe Hypodermic needle

Kinds of Parenteral Drug Containers : 

42/95 Kinds of Parenteral Drug Containers Glass ampules Single and multidose vials Nonconstituted syringes Prefilled syringes Intravenous medication fluids

Ampules and Vials : 

43/95 Ampules Vials Ampules and Vials

Information on Drug Labels : 

44/95 Information on Drug Labels Name of medication Expiration date Total dose and concentration

Obtaining Medication from a Glass Ampule : 

45/95 Obtaining Medication from a Glass Ampule

Hold the ampule upright and tap its top to dislodge any trapped solution. : 

46/95 Hold the ampule upright and tap its top to dislodge any trapped solution.

Place gauze around the thin neck… : 

47/95 Place gauze around the thin neck…

…and snap it off with your thumb. : 

48/95 …and snap it off with your thumb.

Draw up the medication. : 

49/95 Draw up the medication.

Obtaining Medicationfrom a Vial : 

50/95 Obtaining Medicationfrom a Vial

Confirm the vial label. : 

51/95 Confirm the vial label.

Prepare the syringe and hypodermic needle. : 

52/95 Prepare the syringe and hypodermic needle.

Cleanse the vial’s rubber top. : 

53/95 Cleanse the vial’s rubber top.

Insert the hypodermic needle into the rubber top and inject the air from the syringe into the vial. : 

54/95 Insert the hypodermic needle into the rubber top and inject the air from the syringe into the vial.

Slide 55: 

55/95 The nonconstituted drug vial actually consists of two vials, one containing a powdered medication and one containing a liquid mixing solution.

Nonconstituted drugs come in separate vials. Confirm the labels. : 

56/95 Nonconstituted drugs come in separate vials. Confirm the labels.

Remove all solution from the vial containing the mixing solution. : 

57/95 Remove all solution from the vial containing the mixing solution.

Cleanse the top of the vial containing the powdered drug and inject the solution. : 

58/95 Cleanse the top of the vial containing the powdered drug and inject the solution.

Agitate or shake the vialto ensure complete mixture. : 

59/95 Agitate or shake the vialto ensure complete mixture.

Prepare a new syringe and hypodermic needle. : 

60/95 Prepare a new syringe and hypodermic needle.

Withdraw the appropriate volume of medication. : 

61/95 Withdraw the appropriate volume of medication.

In the Mix-O-Vial system, the vials are joined at the neck. Confirm the labels. : 

62/95 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. : 

63/95 Squeeze the vials together to break the seal. Agitate or shake to mix completely.

Withdraw the appropriate volumeof medication. : 

64/95 Withdraw the appropriate volumeof medication.

Prefilled or Preloaded Syringes : 

65/95 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 : 

66/95 Parenteral Routes Intradermal injection Subcutaneous injection Intramuscular injection Intravenous access Intraosseous infusion

Slide 67: 

67/95 Intradermal Injection

Assemble and preparethe needed equipment. : 

68/95 Assemble and preparethe needed equipment.

Check the medication. : 

69/95 Check the medication.

Draw up the medication. : 

70/95 Draw up the medication.

Prepare the administration site. : 

71/95 Prepare the administration site.

Pull the patient’s skin taut. : 

72/95 Pull the patient’s skin taut.

Insert the needle, bevel up ata 10-degree to 15-degree angle. : 

73/95 Insert the needle, bevel up ata 10-degree to 15-degree angle.

Remove the needle and cover the puncture site with an adhesive bandage. : 

74/95 Remove the needle and cover the puncture site with an adhesive bandage.

Monitor the patient. : 

75/95 Monitor the patient.

Subcutaneous Injection : 

76/95 Subcutaneous Injection

Subcutaneous Injection Sites : 

77/95 Subcutaneous Injection Sites

Prepare the equipment. : 

78/95 Prepare the equipment. © Scott Metcalfe

Check the medication. : 

79/95 Check the medication. © Scott Metcalfe

Draw up the medication. : 

80/95 Draw up the medication. © Scott Metcalfe

Prep the site. : 

81/95 Prep the site. © Scott Metcalfe

Insert the needle at a 45-degree angle. : 

82/95 Insert the needle at a 45-degree angle. © Scott Metcalfe

Remove the needle and cover the puncture site. : 

83/95 Remove the needle and cover the puncture site. © Scott Metcalfe

Monitor the patient. : 

84/95 Monitor the patient. © Scott Metcalfe

Intramuscular Injection Sites : 

85/95 Intramuscular Injection Sites Deltoid Dorsal gluteal Vastus lateralis Rectus femoris

Intramuscular Injection : 

86/95 Intramuscular Injection

Intramuscular Injection Sites : 

87/95 Intramuscular Injection Sites

Prepare the equipment. : 

88/95 Prepare the equipment. © Scott Metcalfe

Check the medication. : 

89/95 Check the medication. © Scott Metcalfe

Draw up the medication. : 

90/95 Draw up the medication. © Scott Metcalfe

Prepare the site. : 

91/95 Prepare the site. © Scott Metcalfe

Insert the needle at a 90-degree angle. : 

92/95 Insert the needle at a 90-degree angle. © Scott Metcalfe

Remove the needle and cover the puncture site. : 

93/95 Remove the needle and cover the puncture site. © Scott Metcalfe

Monitor the patient. : 

94/95 Monitor the patient. © Scott Metcalfe

Summary : 

95/95 Summary Aseptic Technique Medication Administration Routes Medication Package Anatomy and Physiology related to Medication Administration

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