CHAPTER 27 TECHNIQUES FOR PARENTERAL DRUG ADMINISTRATION

CHAPTER 27 TECHNIQUES FOR PARENTERAL DRUG ADMINISTRATION

Parenteral administration of drugs is carried out by injection, for which syringes and hollow needles are used (Fig. 77). The syringe consists of a cylinder and a piston, the latter must fit tightly to the inner surface of the cylinder, ensuring tightness, but at the same time slide completely freely over the surface. Injection cylinder capacities: 1, 2, 5, 10, 20, 50 ml. The choice of syringe depends on the type of injection and the amount of drug administered. So, up to 0.5 ml of solution is injected intradermally, 0.5-2 ml subcutaneously, intramuscularly - 1.0-10 ml, intravenously - 10-20 ml, into the cavity - 10-50 ml.

Rice. 77. Types of syringes:

a - disposable; b - “Record”; c - combined; g - Janet syringe; d - a set of needles for syringes

In recent years, syringes for single use made of plastic have been used in medical practice; to every such

Each syringe comes with 1-2 needles. They are in special packaging, sterile and ready to use. The use of disposable syringes is an effective way to prevent infection with viral serum hepatitis and HIV infection

In the practice of children's medical institutions, disposable 2- and 5-gram syringes are mainly used. In some cases, it becomes necessary to use reusable syringes. For this purpose, use a “Record” type syringe with a glass cylinder with metal tips and a piston, and its analogues. The combination syringe has a metal tip on only one side. An insulin syringe is intended for administering small doses, and a syringe pen is intended for the same purposes (Fig. 78). The Janet syringe is intended for administering large doses of medicinal substances with a capacity of up to 150 ml.

Rice. 78.Insulin syringes: disposable (a), pen syringe (b)

Reuse of disposable and unsterilized reusable syringes is not allowed.

Hollow needles come in 10 gauges depending on the diameter. The choice of needle diameter depends on the intended nature of the injection. Intradermal injections are made with needles of the smallest diameter; for intravenous injections, larger diameter needles are usually used; needles for subcutaneous and intramuscular administration occupy an intermediate position. In addition, the choice of needle gauge depends on the consistency of the drug to be administered. For injection of oil solutions, larger diameter needles are used than for injection of aqueous solutions, etc.

Remember: the medicine, its dose, method and interval of administration are prescribed by the attending physician.

Injection site is chosen so as not to injure the vessels, nerves, and periosteum. Injections are not performed in places where the skin is affected by pustular diseases, scars, hemangiomas and nevi. Before the injection, the skin is disinfected with alcohol or 5% iodine tincture. In children, a more concentrated iodine tincture cannot be used, as it can cause skin burns.

Before assembling sterile instruments, the nurse should treat your hands: Wash them thoroughly with soap; if there are scratches, hangnails, or sores, disinfect them with alcohol. It is unacceptable to have rings or bracelets on your hands. After hand treatment, sterile gloves are put on them, and the sleeves of the robe are first rolled up to the middle of the forearms.

Before you give the injection,

Make sure that the ampoule contains the medicine that needs to be administered;

See if its expiration date has expired, if the packaging is intact, pay attention to the dose and concentration expressed as a percentage;

Before use, wipe the cap of the bottle or ampoule with ethyl alcohol, and use it on your gloves if you have touched any object before.

Needles used to draw the contents of the ampoule into a syringe or pierce the rubber stopper of the bottle cannot be used for injections. For injections use a different needle. When putting a medicine into a syringe, each time you carefully study the label first to avoid any mistakes.

Before injection, the air must be removed from the syringe. To do this, you need to turn the syringe with the needle up, and the air collects above the liquid in the outlet part of the cylinder, from where it is forced out through the needle by the movement of the piston. Usually, a certain amount of the drug is also squeezed out. Therefore, it is recommended to fill the syringe with a slightly larger amount of the drug than is necessary for injection.

When washing syringes and needles, use solutions containing hydrogen peroxide in combination with detergents (“Novost”, “Progress”, “Sulfanol”), taken in a 1:1 ratio. To prepare the washing solution, take 20 ml of 30-33% perhydrol (or 40 ml of 1% hydrogen peroxide solution), 975 ml of water (in the second case - 950 ml), 5 g of detergent (in the second case - 10 g). After disassembling, the syringes and needles are washed and rinsed in running water, then soaked for 15 minutes in a hot (50-60 ° C) washing solution, immersing them so as to fill the cavities. After soaking, syringes and other instruments are washed in the same solution with brushes or gauze swabs, each separately. The solution is used once. Washed syringes and needles are rinsed again in running water, then in distilled water. Disassembled syringes and needles are stored in a dry place.

Most hospitals have centralized sterilization facilities for instruments, including syringes and needles.

Children gradually get used to the injections. However, when administering the first injection, the healthcare worker should be especially attentive and sensitive and not cause unnecessary stress in the child. You should never deceive a child. He must know that he will be given an injection and that it will hurt, but not as much as he imagines. Not only is the skin puncture painful, but also the moment of drug administration, especially if it is administered quickly. The procedure should not be delayed and at the same time the injection itself should be done without much haste.

Anesthesia methods used for subcutaneous and intramuscular injections:

Finger pressure - the tip of the index finger with cotton wool is immersed at the site of the intended injection to a depth of at least 1 cm, mentally counting for 10 seconds, then the cotton wool is removed and at the same time the needle is inserted into the formed dimple;

Stretching the skin - the closed tips of the thumb and index fingers are pressed into the site of the intended injection to a depth of at least 1 cm, mentally counted for 10 seconds, then the immersed fingers are moved apart to 2 cm, the resulting dimple is treated with alcohol and a needle is inserted at a given angle to the required depth;

Using plastic tubes with rounded ends - they are pressed at a given angle to a depth of at least 1 cm, mentally counted for 10 seconds, a needle is inserted into the tube to the required depth, after the injection the tube is removed along with the needle.

In pediatric practice, needleless injectors that do not cause pain can be used. They are used primarily for vaccination, when it is necessary to vaccinate a large number of children in a short time. Restrictions on the introduction of needle-free injectors into widespread practice are associated with difficulties in ensuring safety during their use, the impossibility of administering a variety of medications, etc. In addition, when using highly purified insulin, the drug is administered using a pen syringe with a sterile microneedle and dispenser.

Intradermal injections. With intradermal injection, the drug is injected into the thickness of the skin itself, usually on the flexor surface of the forearm or the outer surface of the shoulder.

For intradermal injection, choose the thinnest needles and a syringe with a volume of 1 cm 3. The site of the intended injection is disinfected with alcohol (it is advisable for children to use 70% ethyl alcohol). The needle is placed with the cut upward in relation to the skin and inserted at an acute angle into the skin so that the needle hole disappears into the stratum corneum. When the injection is carried out correctly, the injected substance forms a whitish elevation in the skin, the so-called “lemon peel”. Once the solution is administered, the needle is removed and the puncture site is wiped with alcohol.

More often, intradermal injection is done for the purpose of immunodiagnosis and to determine the hydrophilicity of tissues (McClure-Aldrich test).

Immunodiagnostics. Usually the test is placed on the inner surface of the forearm. After treating the skin with alcohol, 0.1 ml of the allergen is injected strictly intradermally with a thin needle to obtain a “lemon”

naya crust.” Due to the use of small volumes of the drug, only tuberculin syringes are used for skin allergy tests. At the same time, for control, 0.1 ml of allergen solvent (saline solution) is also injected intradermally on the other forearm.

The name of the allergen drugs used, as a rule, corresponds to the name of the disease: for example, tuberculin is used to diagnose tuberculosis, brucellin - brucellin, tularemia - tularin, anthrax (anthrax) - anthraxin. If a child has a corresponding disease at the site of drug administration, a local allergic reaction develops, manifested in the form of hyperemia, infiltration and edema. Using the Mantoux test with 2 tuberculin units, both infectious and post-vaccination allergies are detected. Unlike post-vaccination allergies, infectious allergies are more persistent and should tend to intensify. The appearance of a positive reaction after previously negative ones, as well as an increase in sensitivity to tuberculin by 6-10 mm, especially by 10-15 mm, indicates a probable infection. The appearance of a positive tuberculin reaction

in a child who has been in contact with a tuberculosis patient is usually regarded as being infected with tuberculosis.

McClure-Aldrich test. To carry it out, 0.2 ml of 0.85% sodium chloride solution (isotonic solution) is injected intradermally and the resorption time of the papule is monitored (normally, in children under 1 year of age, the blister resolves in 15-20 minutes, in children 1-5 years old - in 20-25 minutes, for older children - 40 minutes).

Subcutaneous injections. For subcutaneous injections, syringes with a volume of 1 to 10 cm 3 and needles of various calibers are used. The most convenient places for subcutaneous injections are

Rice. 79.Areas of the body used for subcutaneous injections (shaded)

outer posterior surface of the shoulder, subscapular region, subcutaneous fatty tissue of the abdomen or thighs (Fig. 79).

The skin is pre-lubricated with alcohol or 5% iodine tincture. Hold the syringe with the thumb and middle fingers of the right hand, with the index and thumb of the left hand, grab the skin with subcutaneous fatty tissue into a fold, pull it upward and towards the needle tip. Then, with a short, quick movement, the needle is inserted into the skin, moving it into the subcutaneous fatty tissue to a depth of 1-2 cm. After this, intercepting the syringe with the left hand, the right hand pulls the plunger back slightly to check whether blood has appeared (if the needle is in the vessel, injection is not performed). In the absence of blood, the medicinal solution is injected under the skin. At the end of the injection, remove the syringe, holding the needle with your finger, and the injection site is re-treated with alcohol.

Insulin administration. Daily multiple subcutaneous injections of insulin are an integral part of the life of children suffering from insulin-dependent diabetes. The most convenient and practical are plastic insulin syringes, packaged with a needle. A thin, sharp needle practically does not injure the skin. You need to be able to correctly use other modern means of insulin administration, which include syringe pens and wearable insulin pumps.

Regular disposable syringes are not suitable for insulin injections. Only special insulin syringes allow you to take the specified volume of medication. And in insulin-dependent diabetes, the exact dose is one of the conditions for successful treatment.

The technique for subcutaneous injection of insulin is as follows: when injecting, the needle should enter the subcutaneous fatty tissue. If you inject superficially, a “bruise” or slight swelling may form, and the medicine will take longer to be absorbed. If the needle is inserted too deeply, insulin will enter the muscle. This is not dangerous, but the drug is absorbed faster from muscle tissue. You need to be especially careful when performing an injection in the arm or thigh of adolescents with well-developed muscles.

Insulin syringes. Plastic syringes with a built-in needle are recommended to eliminate the so-called dead space, in which a certain amount of solution remains in a regular syringe with a removable needle after injection. Plastic syringes can be reused - provided they are used correctly

handling them. It is desirable that the dividing price of an insulin syringe for children should be 0.5 units, but not more than 1 unit.

Insulin concentration. Plastic syringes for insulin are available in concentrations of 40 U/ml and 100 U/ml.

Mixing insulins in one syringe. The advisability of mixing insulin is explained by the possibility of reducing the number of injections. However, the ability to mix short- and long-acting insulins in one syringe depends on the type of long-acting insulin. Only insulins that contain protein (NPH insulins) can be mixed. Do not mix so-called human insulin analogues. The sequence of actions when drawing two insulins into one syringe: first, draw short-acting insulin (clear), then long-acting insulin (cloudy). They act carefully so that part of the already collected “short-acting” insulin does not end up in the bottle with the extended-release drug.

Insulin injection technique. The rate at which insulin is absorbed depends on where the needle is inserted. Insulin injections should always be given into subcutaneous fat, but not intradermally or intramuscularly. Often patients do not form a fold and inject at a right angle, which leads to insulin entering the muscle and unpredictable fluctuations in glycemic levels.

The thickness of the subcutaneous tissue in children is often less than the length of a standard insulin needle (12-13 mm). To avoid the possibility of intramuscular injection, use short insulin needles - 8 mm long (Becton Dickinson Microfine, Novofine, Disetronic). They are the thinnest needles and “painless”: the diameter of the shortened needle is only 0.3 or 0.25 mm (the diameter of standard needles is 0.4, 0.36 or 0.33 mm). Shorter (5-6 mm) needles are also available, but further reduction in length increases the likelihood of intradermal penetration.

Insulin injection sites. Several areas are used for insulin injections: the front surfaces of the abdomen, thighs, outer surface of the shoulders, buttocks. The rate at which insulin is absorbed depends on which area of ​​the body it was injected into (the fastest is from the abdomen). Before eating, it is better to inject short-acting insulin into the anterior surface of the abdomen. Long-acting insulin injections can be given in the thighs or buttocks. The injection site should be changed daily to avoid fluctuations

blood sugar levels. When alternating injection sites, it is necessary to deviate from the previous injection site by more than 2 cm.

Syringe pens. In addition to plastic insulin syringes, semi-automatic dispensers are increasingly used - the so-called insulin syringe pens. Their device resembles an ink fountain pen, in which instead of an ink reservoir there is an insulin cartridge, and instead of a pen there is a disposable needle. Almost all foreign insulin manufacturers produce syringe pens: Novo Nordisk, Eli Lily, Aventis, etc. They can improve the patient’s quality of life: there is no need to carry a bottle of insulin with you and draw it with a syringe. This is especially significant in intensive insulin therapy regimens, when the patient has to take many injections during the day.

The latest generations of syringe pens allow you to administer the entire dose at once, and not discretely, as with the first generations of pens, when only 1 or 2 units could be administered. In Russia, syringe pens are now used, into which a 3 ml cartridge (300 units of insulin) is inserted: “Novopen 3”, “Humapen”, “Opti-pen”, “Innovo”.

The disadvantage of syringe pens is the inability to simultaneously mix and inject short- and long-acting insulins in an individually selected ratio (for example, as in a syringe for intensified insulin therapy); in this case, you have to make injections twice, using two “pens” separately.

The Novopen 3 syringe pen is designed for administering insulin from Novo Nordisk. It has a body made of plastic and metal; allows you to simultaneously administer up to 70 units of insulin, with an injection step of 1 unit. In order to avoid confusion when using different insulins, multi-colored syringe pens are produced. For children, there is a modification “Novopen 3 Demi” with an insulin dose rate of 0.5 units.

Humapen syringe pen from Eli Lily. The pen is easy to use: the cartridge allows you to inject up to 60 units of insulin at a time, it is easily recharged, and you can correct an incorrect dose. Colored inserts on the body are designed for the use of various insulins. The dose increment is 1 unit.

Syringe pen "Optipen" from Aventis. Its main difference is the presence of a liquid crystal display, which displays the dose to be administered. The Optipen Pro 1 model allows one-

instantly administer up to 60 units of the drug, the number “1” means that the dose increment is 1 unit. It is impossible to set a dose greater than the amount of insulin left in the cartridge.

Syringe pen "Innovo" from Novo Nordisk. Like Optipen, the dose is displayed on the liquid crystal display; The length of the device has been reduced. An electronic control system guarantees accurate administration of the dialed dose. The range of administered doses is from 1 to 70 units, the dosing step is 1 unit. The set dose can be increased or decreased by simply turning the doser forward or backward without losing insulin. The main difference between Innovo and other syringe pens is that it shows the time that has passed since the last injection and “remembers” the last dose of insulin.

Changing needles The quality of insulin needles ensures comfortable insulin administration. Ideally, single use of insulin needles should be recommended; in addition, after each injection of insulin, the needle must be removed immediately. The needle point is specially sharpened and lubricated using the latest technology. Repeated use of the insulin needle will damage the needle tip and wear off the lubricant coating. The main argument against repeated use of a needle is not even an increase in pain, but microtrauma to the tissue. Repeated use of the needle can cause insulin crystals to clog the channel, which in turn makes delivery of the drug difficult and the dose inaccurate. The same thing happens if you do not remove the needle after the injection, resulting in insulin leakage and air entering the vial.

Intramuscular injections. With intramuscular injections, drugs are absorbed faster than with subcutaneous injections, due to the abundance of lymphatic and blood vessels in the muscles.

For intramuscular injections, the area of ​​the upper outer quadrant of the buttock or the anterior outer area of ​​the thigh is usually chosen (Fig. 80). Intramuscular injection is performed according to certain rules.

Using a file or emery cutter, file down the narrow part of the ampoule and break it off. The lid of the bottle is pierced with a needle. The medicine is drawn in slowly by pulling back the piston. The amount of solution is determined by the divisions marked on the walls of the cylinder (Fig. 81, a). The needle used to draw up the medicine is removed and an injection needle is put on. The syringe is installed vertically with a needle

Rice. 80.Intramuscular injections into the upper outer quadrant of the buttock (a) and the anterior outer region of the thigh (b)

upward, carefully remove air from it until a few drops of medicine appear at the end of the needle (Fig. 81, b). Mentally, the surface of the buttock is divided into four equal parts. The middle of the uppermost square will be the area into which the medicine is injected. They treat it with cotton wool and alcohol and ask the sick child to relax his muscles (Fig. 81, c).

Hold the syringe in your right hand (like a pen) with the needle down, perpendicular to the surface of the body. With the left hand, collect the skin and muscles into a wide fold and vigorously insert the needle (Fig. 81, d). For intramuscular injections, the needle (its length is 60 mm, diameter is 0.8-1 mm) is inserted to a depth of 3-4 cm. To prevent it from entering the vessel, the piston is slightly pulled up and then the drug is injected (Fig. 81, d). The needle is removed quickly, in one movement, the injection site is lightly pressed with cotton wool, which was used to treat the skin before injection (Fig. 81, e). You should not clap or massage the injection site.

It is better to give an intramuscular injection while the patient is lying down. Sometimes it happens that the hand trembles, the needle enters a tense muscle or damages a vessel. You should remove the needle, change the needle to a sterile one and repeat the procedure, inserting the needle next to it in another place.

Rice. 81.Rules for performing intramuscular injection. Explanation in the text

Repeated injections are usually not given in the same place.

To facilitate intramuscular injections, especially at home, a Kalashnikov syringe pistol is used. The device allows you to fix the syringe and independently regulate the force and depth of needle penetration. The needle exactly follows the nurse’s movements, so the injection does not cause any pain to the child.

Attention: the Kalashnikov syringe pistol is intended only for intramuscular injections with 5 ml syringes.

With intramuscular injections the following are possible: complications:

a) infiltrates may form, which is associated with non-compliance with aseptic rules. In this regard, it is necessary to periodically palpate the injection sites and, if an infiltrate is detected, treatment methods such as distraction procedures should be used without delay. The simplest measures are applying an “iodine” mesh to the skin in the area of ​​infiltration, applying a semi-alcohol compress, and among physiotherapeutic measures - ozokerite applications, UHF electric field. All these procedures are aimed at preventing the development of an abscess, the treatment of which is only possible through surgery;

b) the needle may break, the end of which remains in the fabric. The needle is removed surgically;

c) nerve trunks may be damaged as a result of incorrect choice of injection site.

Intravenous injections and intravenous drips(Fig. 82, a, b). When administered intravenously, drugs immediately enter the general bloodstream and have a rapid effect on the body.

For intravenous infusions, large-capacity syringes (10 and 20 cm3) and larger diameter needles with a short bevel are used. Infusions are given into peripheral veins. For children in the first year of life, intravenous injections are given into the saphenous veins of the head, for older children - more often into the ulnar veins, less often - into the veins of the hand or foot. Intravenous infusions into the veins of the neck and subclavian veins are done in extreme and exceptional cases with extreme caution. This is due to the fact that the pressure in the neck veins is lower than atmospheric pressure, there is a danger of air being sucked in and air bubbles entering the bloodstream (air embolism).

Rice. 82.Peripheral venous puncture:

a - the most convenient places for venous puncture; b - puncture of the head vein and fixation of the needle; c - puncture of the vein using a butterfly needle and fixation of the needle; d - fixation of the limb during venipuncture

Before intravenous infusion, wash your hands thoroughly and wear disposable gloves. The child's position is usually lying on his back. The skin is disinfected with alcohol. To better fill the vein, it is recommended to clamp it above the intended injection site. This can be done with your finger (for better filling of the veins of the head in young children) or by applying a tourniquet (on the limbs).

A vein is punctured with a needle without a syringe (except for the neck veins) or with a needle attached to a syringe. The direction of the needle is along the blood flow, at an acute angle to the surface of the skin. The skin is punctured with a quick movement and to a shallow depth. Then, by briefly moving the needle forward, the vein is pierced, being careful not to pass through its opposite wall. Then the needle is advanced along the vein. When it enters a vein, dark venous blood appears at the outer end of the needle.

Lack of blood is usually due to the needle missing a vein. In premature babies and seriously ill infants, due to changes in blood viscosity, the latter does not always flow out of the needle, even when the needle is in the vein. To clarify the location of the needle tip, sterile cotton wool rolled into a flagellum is inserted into the cannula. Staining of the flagellum with blood indicates that the needle has entered a vein. If the needle does not get into the vein, then it is returned back without removing it from under the skin, and another attempt is made to get into the lumen of the vein. If the puncture is successful, blood is collected from a vein for laboratory testing or a medicinal solution is administered intravenously.

The administration of drugs into a vein (infusion) is carried out slowly, taking into account the rapid action of the injected substance. Care must be taken to ensure that the injected substance only enters the vein. If the syringe plunger does not move forward well or swelling appears at the infusion site, then the needle has left the vein and the substance is entering the tissue surrounding the vein. In this case, the infusion must be stopped and the vein puncture repeated in another place. After the procedure, the needle is quickly removed from the vein parallel to the surface of the skin so as not to damage the vein wall. The puncture site is re-treated with alcohol and a sterile pressure bandage is applied. If the injection is performed correctly, there should be no bleeding. The doctor administers the intravenous injections and is assisted by the nurse.

The following complications are possible during venipuncture:

a) hematoma, which forms when the wall of a vein is punctured. It can be moderately painful, but quickly resolves when a pressure bandage is applied;

b) bleeding from the puncture site of the vein, which is observed with blood clotting disorders. It usually stops quickly when a pressure bandage is applied. It is less common to use special methods to stop bleeding;

c) tissue inflammation and the formation of infiltrates at the injection site, which are observed in cases where the drug

the solution enters the surrounding tissue. The rapid resorption of infiltrates is facilitated by the application of warm compresses.

In order to prevent complications, you should be especially careful about sterilizing instruments, treating the hands of a medical worker and the patient’s skin, as well as the sterility of injected solutions.

No more than 50-300 ml of liquid can be injected at a time, depending on the body weight and age of the child. With the jet injection of a large amount of fluid, heart failure may develop due to overload of the right side of the heart.

If it is necessary to introduce a significant amount of liquid, then use the drip infusion method. Venous puncture is carried out in the usual way. The needle is connected to a special dropper, which allows you to regulate the speed of droplet fall in the dropper socket. For drip infusions, especially those designed for a long time, butterfly needles and special catheters for intravenous infusions are also used (Fig. 82, c).

Tubes for the drip infusion system can be plastic or rubber. In a disposable system, a special tap or clamp allows you to adjust the infusion rate (based on the number of falling drops per minute). The cylinder with the medicinal solution is suspended on a special tripod. Pressure regulation is achieved by raising or lowering the tripod. It is necessary to create a so-called “stagnant lake” of liquid in the dropper. Before connecting the system to the needle, liquid is passed through the entire system, then a tube is clamped near the cannula, due to which a “stagnant lake” is formed. Before connecting the drip system to a needle or catheter, check to see if there is any air left in the system.

To temporarily interrupt the drip infusion, you can insert a sterile mandrel into the needle or simply clamp the catheter. To preserve the vein for further infusions, a cannula inserted into a catheter is widely used (in the absence of special catheters). A rubber tube 3-4 cm long is put on the cannula, folded in half and tied. A seal is also created at the junction of the rubber tube and the cannula.

To maintain the patency of the needle or catheter (preventing blood clotting), a so-called heparin lock is made. Mix 1 ml of heparin and 9 ml of isotonic chloride solution

sodium, then 1 ml of the mixture is injected through a cannula or needle and the catheter is clamped or a mandrel is inserted into the needle.

Drip administration of medications requires time, which requires fixation of the limb and ensuring long-term rest. The needle is fixed in the vein as follows: a sterile cotton swab is placed under the needle, and on top it is attached to the skin with an adhesive plaster. It is recommended to use transparent film dressings of the ZM Tegaderm type, specially designed for catheterization of peripheral and central veins. Film dressings eliminate the risk of infections associated with catheter installation.

Immobility of the limb is imparted by immobilizing it in a splint or splint; sometimes the hand is fixed to the bed (Fig. 82, d).

When performing intravenous drip infusions, the following complications are possible:

a) air embolism, which occurs when air enters a vein from a syringe or dropper, especially at the time of jet injection of liquid. If pyrogenic or allergic reactions occur, which are expressed in chills, fever, skin rashes, nausea or vomiting, it is necessary to stop further administration of solutions into the vein and inform the doctor about this, since special treatment measures are required;

b) the development of phlebitis, to reduce the risk of which the following rules must be followed:

The temperature of the fluid administered intravenously should be equal to the patient’s body temperature or at least correspond to room temperature;

Droppers must be changed daily;

Strict sterility must be observed;

Hypertonic solutions are administered through other veins. If signs of phlebitis appear, a bandage with Vishnevsky ointment or heparin ointment is applied to the affected area, and the dropper is removed;

c) the formation of blood clots, which can also cause an inflammatory process; in the absence of contraindications, small doses of heparin are administered to prevent thrombosis. It is noted that when the rate of administration of the drug is less than 7-8 drops per 1 minute, the vein quickly thromboses.

Fixation of catheters and needles. Various techniques are used to secure silicone feeding catheters, peripheral intravenous catheters, nasal cannulas and electrodes:

Fixing patch;

Special semi-permeable films;

Pectin barriers;

Special hydrocolloid coatings;

Hydrogels (when taking electrocardiograms and conducting

Ultrasound).

It is recommended to secure catheters, needles, and endotracheal tubes using special medical films to protect the skin. The use of a medical adhesive plaster as a skin fixative poses a certain danger, since even minor damage to the skin, especially in newborns, allows hospital strains of microorganisms to penetrate into the soft tissues of the child; in addition, excessive compression is possible, leading to soft tissue necrosis.

The child's skin is damaged when the adhesive plaster is roughly removed, so you should carefully and slowly remove the adhesive plaster strips, after moistening them with water, liquid soap, mineral oil or Vaseline. If, when stretched horizontally, the strip does not peel off from the skin, you need to moisten it again with a gauze swab.

Drip infusions must be carried out strictly in accordance with the doctor’s prescription. It is recommended to use devices for intravenous dosing of fluids (Fig. 83). In their absence, the nurse constantly monitors the rate of fluid administration (by the number of drops per minute) and the good condition of the entire system as a whole.

Often there is a need for sequential administration of medicinal solutions from several bottles. In these cases, they do this: when a small amount of solution remains in the first bottle, close the clamp, quickly remove the air duct from the bottle and insert it into the stopper of the second bottle, which is previously mounted on a stand. Quickly rearrange the needle for the bottle on the short part of the drip system. Open the clamp and regulate the rate at which drops enter the “stagnant lake.”

If additional administration of the drug is necessary during drip infusion, it is administered through the “node for

Rice. 83.Devices for intravenous dosed administration of liquids: a - jet; b - drip

injection" - a rubber tube in the system, using a needle with a cross-section of up to 1.2 mm. The tube is pre-treated with alcohol.

Long-term drip infusions with parenteral nutrition require distribution of the dose of administered substances over 24 hours.

Parenteral administration of drugs in newborns. The administration of drugs in newborns has its own characteristics. Thus, when using various drugs orally, undesirable effects are possible due to the vulnerability of the mucous membrane of the gastrointestinal tract of an immature organism. Newborn babies are prone to regurgitation, gas formation in the stomach, and they often develop intestinal dysbiosis. The rectal route of drug administration to newborns is gaining increasing popularity, although it does not provide sufficient concentrations of some drugs in the blood. The inhalation method of administering drugs is used primarily for oxygen inhalation, as well as for inhalation of aerosols in the treatment of bronchopulmonary diseases.

Any injection in newborns requires the strictest asepsis and antiseptics; For intravenous infusions, polyvinyl chloride catheters are used. Intramuscular injections in newborns, especially premature ones, should be kept to a minimum due to their traumatic nature - only underdeveloped muscles can suffer (necrosis may occur), but also the child’s extremely vulnerable nervous system. Anesthetic creams have been developed especially for newborns and infants to prepare the skin area for injection - EMLA or 2% lidocaine gel. Intramuscular injections are made into the quadriceps femoris muscle, as it is the most developed muscle in children of this age; with injections into the gluteal muscles, severe complications may develop (neuritis, thrombosis).

Intravenous administration should be carried out slowly (1-2 ml/min with simultaneous administration). During drip infusion, it is necessary to monitor the level of the administered drug in plasma. The use of intravascular lines requires careful care of them, since during infusions there is always a threat of complications: infection of catheters, development of thrombosis, thrombophlebitis, peripheral necrosis, hemorrhage, etc.

The rate of drug elimination, as a rule, is significantly reduced in premature infants, which requires strict regulation of the doses of administered drugs.

General child care: Zaprudnov A. M., Grigoriev K. I. textbook. allowance. - 4th ed., revised. and additional - M. 2009. - 416 p. : ill.

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Unfortunately, no one is immune from diseases. It is especially unpleasant and always difficult when a child is sick. Depending on the form and severity of the problem, the doctor prescribes various medications, but they can only act on the disease and help get rid of it if they enter the body.

In more or less mild cases, the baby will, of course, be prescribed syrups, mixtures or tablets, but it happens that the disease turns out to be too serious, which means that without injections treatment will be ineffective and impossible.

If you and your child are undergoing inpatient treatment in a hospital, then, of course, a nurse will do the injections, but what if, due to some circumstances, you have to get sick at home, and it is not possible to call a qualified specialist every day to carry out the manipulation? In this case, it is worth mastering the technique of performing injections on your own, especially since such a skill may come in handy more than once in life.

What are the types of injections for young children: the main types of injections and their features

First of all, it is worth understanding some important nuances and types of procedures.

The process popularly referred to as an “injection” is called “injection” in medical terminology and means the introduction of liquid into the body using a syringe.

The purpose of injections is considered a rather controversial and ambiguous issue, since the achievements of modern pharmacology make it possible today to do without injections in most cases of diseases, including even pneumonia and other equally serious diseases.

The desire to limit the number of injections as much as possible and narrow the range of indications for them is forcing the best pharmacological companies in the world to create new fast-acting drugs that will have the same effective effect as injections, but without the possible unpleasant injection consequences:

• for example, the risk of infection during manipulation due to violation of sterile conditions is not at all uncommon - we can talk about both banal staphylococcus and such terrible diseases as viral hepatitis B or AIDS;
• sometimes body tissues react to the injection with severe redness, irritation and swelling, and in addition, if the medicine is administered incorrectly, a hematoma or abscess may form at the injection site, which is fraught with new troubles and problems;
• if the tablets or mixture can simply provoke an allergic reaction, then the injection can cause anaphylactic shock with a fatal outcome;
• many injections have a whole range of side and specific effects, such as magnesia or hot injections of calcium chloride;
• drugs in injections are always more expensive than their tablet counterparts, plus - take into account the work of the nurse if for some reason you cannot administer the medicine yourself;
• after all, not only children, but also adults are afraid of injections, because it is a truly unpleasant and very painful process.

However, even taking into account all the above-mentioned disadvantages of injections, many are still at the mercy of the stereotype, believing that there is no effective treatment without injections, and doctors prescribe them, wanting to play it safe and please demanding patients. Although, of course, there are cases when injection is practically the only way to help.

Therefore, you should not use injections to be on the safe side, because to prescribe injections there must be certain indications:

• if immediate therapeutic effect is necessary;
• if a small patient cannot take the medicine due to loss of consciousness / severe vomiting, etc.;
• the medicine cannot be taken orally because it does not have the ability to be absorbed into the blood or is destroyed in the gastrointestinal tract;
• the drug will have a stronger effect or its effect will be much longer when administered by injection.

Types of injections

If we talk about types of injections, there are several of them. The following three types are considered the most common.

1. Subcutaneous administration of the drug (abbreviated as s/c).
2. Intramuscular injections (IM).
3. Intravenous administration of drugs and solutions (IV).

The first type of injections is mainly represented by vaccinations. It is used in cases where an immediate effect from the administered drug is not required, since it can only begin to act when it enters the blood, and there are fewer blood vessels under the skin than in the muscle.

To give such an injection, you need to slightly pull and fold the skin on the shoulder, under the shoulder blade, on the thigh or side of the abdomen, and then place the needle between the muscle and the skin and inject the drug under the skin.

The second type is the most common: doctors prescribe intramuscular administration of vitamins and antispasmodics, antibiotics and antipyretics. The popularity of intramuscular injections is also explained by their availability and relatively simple technique, so if you wish, you can and should learn how to do this type of injection yourself.

Intramuscular administration of the drug, as a rule, occurs in the area of ​​the buttocks, that is, in the butt, since it is in the gluteal muscles that there is the most powerful layer of muscle tissue, which has a small number of nerve endings. However, drugs can be injected into both the hip and shoulder.

Intravenous administration of medication requires professional medical training, so it is recommended that such procedures be performed only by nurses and doctors. There are two subtypes of intravenous injections:

• “jet” injection of medicine with a syringe into a vein - the manipulation is performed at least slowly, but not for long;
• infusion or administration of a large volume of liquid using a dropper - used in cases where the drug will be more effective when administered slowly and diluted.

In addition, there are some other types of injections: for example, tests for sensitivity to antibiotics or before the introduction of therapeutic serums are done intradermally, and an injection can also be made into the spinal canal (for meningitis) or into the joint cavity (for arthritis), and if necessary local anesthesia, as in the case of dental treatment, the doctor will inject directly into its nerve trunks.

Choosing the right everything you need

Now let's look at the issue of preparing and choosing everything necessary to perform the injection.

So, here's what you'll need to buy at the pharmacy.

• The medicine your baby was prescribed by your doctor. Be sure to check the expiration date on liquid ampoules or dry powder bottles. Also, be sure to ensure that the dosage matches the prescription.
• If the drug is not in ampoules, but in the form of a dry powder, then a solvent will still be needed to prepare the injections - this could be lidocaine or novocaine, saline solution or some other agent. Be sure to look in the instructions for the drug to see how and how to dilute it correctly.
• Syringes - take only disposable ones. As for size, it is necessary to take into account the volume of medicine that will need to be administered, but often a two-milliliter syringe will be enough for children, although sometimes a smaller or larger syringe may be needed.
• Needles - usually come complete with disposable syringes. You should check whether the needle is suitable for the injection you need, as they come in oil and water injections.
• In order for the needle to go under the skin easily and less painfully, you need to choose it correctly: for a baby under one year old there is no reason to take a syringe larger than one milliliter - they come with the thinnest needles; for children from one to five years old, as mentioned, syringes will be needed a volume of two milliliters with needles measuring 0.5×25 millimeters; for an older child, the same syringe may be suitable or the needle size will be a little larger - 0.6×30 millimeters.
• You will also need 96% rubbing alcohol as an antiseptic.
• Don’t forget to prepare sterile cotton wool or cotton balls, and a special file blade with which to open the ampoules.

Getting ready for manipulation

Having prepared everything necessary for the procedure, you can proceed to its actual implementation.

To make this not-so-pleasant process as calm and painless as possible for your baby, you should adhere to some simple but mandatory rules:

• Before you begin any manipulations, you need to wash your hands well with soap, or better yet, further disinfect them with medical alcohol or alcohol wipes;
• neither the syringe nor the needle needs to be opened in advance - it is better to print the kit immediately before the injection is given;
• since it is still unclear to the baby what the meaning and purpose of your preparations are, try to do everything quickly, but carefully and calmly, since chaotic movements or panic can frighten him and prepare him in advance for an unpleasant procedure;
• Taking an ampoule with medicine, warm it a little in your palm so that the injection is not cold;
• if there are no special instructions from the doctor, then the injection should be done in the butt, especially since if you are not a professional when it comes to injections, then after injections into the arm or thigh some negative consequences may occur;
• before giving the injection, it is better to stretch the muscles of the baby’s buttocks with light massage movements that do not cause tension, while your hands should be warm;
• the procedure should be carried out in a place where both you and the child will be comfortable - keep in mind that the baby should lie on his tummy during the injection, and also make sure that there is sufficiently bright lighting there;
• Before opening the medicine, check its expiration date again and be sure to check the dosage and name of the medicine with the prescription;
• the ampoule should also be wiped with sterile gauze or cotton wool soaked in medical alcohol;
• do not break off, do not beat off and, of course, do not bite off the tip of the ampoule - to open it correctly, use a special file, otherwise there is a risk that small fragments will get inside when opening;
• using this device, you need to make a small incision / notch on the ampoule along the line of the intended break - that is, just run a nail file along it with pressure several times, but before that, shake the ampoule a little and tap its tip with your fingernail so that the medicine flows down;
• if you are afraid of cutting yourself, wrap the ampoule with a napkin and press its tip away from you;
• Having opened the medicine, set it aside for a couple of seconds and use the syringe;
• unpack it from the piston side and connect it to the needle directly inside the package without removing the protective cap from it;
• It’s good if the kit contains two needles - the one that is long and coarser, you will pierce the stopper of the bottle with the drug or you can lower it into the very depths of the ampoule, and the other - small and thin - then you will give the injection, the kit should come with them and sterile tweezers, with which you can change the first needle for the second;
• so, remove the cap from the needle and lower the piston of the syringe with the needle all the way into the ampoule or bottle of medicine, so that no air enters the syringe;
• slowly and carefully draw in the liquid, pulling the piston towards you;
• it is better to take a little more medicine than needed, since then you will need to release excess air from the syringe - to do this, make a few clicks on the syringe so that the air bubbles rise up, and, turning it over vertically, gradually press the plunger until a drop of liquid will not appear at the tip of the needle;
• After this, you can close the needle with a cap.

If the medicine prescribed for your child is not sold in ampoules with liquid, but in bottles with dry powder, then you will need to do the following:

• all manipulations with preparing the syringe will be the same;
• Taking a bottle of powder, also wipe it with sterile gauze or cotton wool with ethyl alcohol and open the metal cap;
• then wipe the rubber cap that was under the metal one, pierce it with a needle and introduce the solvent;
• shake the bottle for a while until the powder is completely dissolved and no grains or lumps remain;
• turn the bottle upside down and draw the solution into the syringe;
• release excess air and replace the needle with a cap.

Pediatricians advise carrying out all preparations out of sight of the child, so as not to once again frighten him with incomprehensible medical manipulations. It is better to prepare in another room or in the kitchen, and then come to the baby, who may be distracted by another family member at this time.

How to do an intramuscular injection into the buttock: step-by-step instructions and detailed explanation

When you have already prepared everything, there is no need to gather your strength for a long time and waste time. Your movements should be careful and measured, but fast.

Do not panic under any circumstances, because the entire success of the procedure depends on the accuracy of your actions.

• Visually divide any baby’s buttock into four identical square-shaped sectors, that is, as if drawing a cross in the middle to make four identical squares.
• Your task is to inject into the center of the uppermost square or quarter of the gluteal muscle, since it is there that there are no vascular nerve bundles, which, if you get into them, can provoke bleeding, cause pain, numbness of the limb and other unpleasant consequences.
• Wipe the area where you will inject with a cotton swab soaked in rubbing alcohol.
• Try to secure the child as much as possible so that he does not accidentally jerk during the injection and break the needle. It’s good if someone from your family helps you - while you administer the medicine, the baby needs to be held, distracted, and comforted.
• If you give the baby an injection yourself, you can put him on his tummy on your lap and hold him in place with your other hand.
• After massaging the baby’s buttocks, with your free hand grab the area where you will inject - the upper outermost part of the butt, and gather it into a fold.
• Then, with a precise and quick movement, insert the needle two-thirds into this thick fold at a strictly ninety-degree angle.
• Continue to hold the needle perpendicular to the plane of the butt, release the buttock, and fix the syringe in your hand with your index and middle fingers, while keeping your thumb on its piston.
• Slowly press the plunger and inject the medicine.
• Press the area on the butt where the needle was inserted with a cotton swab soaked in alcohol, and with a quick, clear movement, pull out the needle.
• Massage the injection site with a cotton swab a little so that the alcohol can disinfect the wound and the medicine can be absorbed faster.
• Cap the syringe needle and throw away the used syringe.

That's all, the unpleasant procedure is over, but if you do everything correctly, the child should feel virtually no pain.

Injections without painful consequences: how to do it to avoid bumps, bruises and lumps after injections

Even professional doctors have failures - they can also accidentally hit a nerve or vessel, causing pain to the patient, and what can we say about those who are trying to give an injection to their baby for the first time in their life.

The main task of mom or dad in this case is to overcome their own fear and cope with their own naughty nerves. You may want to try practicing on a pillow or dummy first, like medical students do, or ask a nurse to observe your actions and correct them if you make mistakes.

Well, in order to minimize the discomfort and pain of the procedure, try to take into account the following nuances:

• use modern three-component syringes with a rubber seal on the piston;
• do not insert the needle slowly and gradually - by doing this you will only prolong the pain and agony, remember about sharpness, speed and clarity of movements;
• but the medicine needs to be injected really slowly - the more carefully and smoothly you inject the liquid, the less likely it is that bruises and lumps will form after the injection;
• rapid administration of the medicine is allowed only if the child is hysterical and breaks out;
• alternate sides of the butt - one day stab into the upper right square, and the next - into the left;
• give injections at a distance of at least one to two centimeters from each other;
• if your baby is prescribed oil injections, then do not forget to warm them up a little in warm water before use, and when you insert the needle into the butt, pull the syringe plunger slightly towards you;
• the appearance of blood may indicate that you have hit a blood vessel directly - try to carefully change the depth of the injection or its direction;
• Massage your child’s buttocks regularly so that the medicine is better absorbed and lumps do not form;
• if lumps or bruises do appear, warm the problem areas with a heating pad and draw an iodine net on the baby’s bottom;
• you can smear the cones with Heparin ointment; Levomikol and Traumeel S also help;
• There are also folk remedies for dealing with seals - some apply a plate of thinly sliced ​​unsalted cheese to them, others - cabbage leaves with honey.

How to calm a child and persuade him to carry out the procedure?

However, the procedure will work best if you first agree with the baby and prepare him mentally for what is about to happen.

Initially, the child does not know what an injection is, how unpleasant or painful it is, scary, etc. However, many parents use the medical topic as the main intimidation of their child, telling him that if he does not eat porridge / he will behave well lead or obey, then you will immediately call a doctor who will inject you with a syringe with a huge needle.

Do you think that after such colorful descriptions the baby will be afraid of all the people in white coats and their terrible weapons - injections? Well, of course yes.

Of course, you will not be able to explain to a newborn or one-year-old baby that this procedure is vital or very necessary for him, that after the injection his tummy, arm or head will stop hurting, that after this he will become healthy again and you can go for a walk / to a cafe for ice cream / to visit or another place desired by the baby. However, from the age of two, all this can and should be said to the child, correctly setting him up for the procedure.

Buy your child a toy doctor's kit, read him a fairy tale about the kind and wonderful doctor Aibolit, play in the hospital with him - let him give injections himself and give medicine to his animals, dolls or cars. At the same time, explain what could be the “cause of illness” in the toys: unwashed hands, swimming in cold water, overeating ice cream, etc.

You can give a joint injection - you to the baby, and he to his favorite bear, “one-two-three”. Some parents try to distract the baby during the procedure with new toys, interesting cartoons or other maneuvers.

Do not deceive your child by telling him that an injection is not painful or scary at all, because, firstly, he is really scared, and secondly, it still hurts. You also cannot hide from a baby with a syringe and try to inject him on the sly or in his sleep - in this case, stress and nervous shock from the procedure can simply lead to unpredictable consequences.

It is also not allowed to scold or reproach the baby in front of strangers, to humiliate and shame him for being afraid of an injection or crying. The child expects support and help from you, especially during an illness, and if you also inflict an additional portion of pain, shame and fear on him, then he will generally withdraw into himself, stop trusting you, and the memory of this will remain with him for the rest of his life. life.

Do not restrain a struggling and hysterical baby by forcibly trying to give him an injection unless this is vitally necessary. It is better to postpone the procedure and first try to calm the child down, talk to him, look for an individual approach, create a comfortable environment, and only then try again.

According to medical statistics, every fifth adult resident in the post-Soviet space has an insurmountable fear of injections. This problem is called “trypanophobia” and is considered a specific disorder.

One of the factors in its appearance and progression is precisely the negative experience from childhood. Therefore, try to do everything possible so that your baby understands the need for injections and is able to cope with his fears and overcome them.

After the procedure is completed, be sure to praise your little hero for enduring everything with steadfastness.

Conclusion

Intramuscular injection is one of the simplest medical procedures. However, even this requires compliance with certain rules. If you have patience and confidence, then you will definitely succeed. Try to respect your child, love him - always and no matter what. And may you need the skill of giving injections as rarely as possible, and may the children grow up healthy!

29.07.2015 2985 3

When a baby appears in the house, sometimes situations may arise when the child needs qualified medical care, but there is no doctor nearby. Young parents do not need to be scared; it is better to learn how to carry out some medical procedures on their own.

One of the most necessary and common medical practices is intramuscular injections for children. This manipulation can be learned in advance and then no disease will take you by surprise. An injection is the administration of medicine using a syringe. Intramuscular injections are most often required.

What do you need to prepare for the injection? (alcohol, medicine, syringe, etc.)

Very simple rules, following which will help to avoid complications:

Wash your hands

Check the medicine (expiration date, dosage, appearance, presence of sediment)

Check with your prescription to see what dose your doctor prescribed. If in doubt, call your doctor!

Check for the presence of a diamond file used to open ampoules

Get alcohol wipes for injections (or sterile cotton wool and alcohol)

Remove the syringe without opening the packaging (check the expiration date and the packaging itself)

Prepare a clean plate, wipe it with alcohol

It is better to perform all these actions so that the baby does not see your preparations. Don't worry him in advance.

Consistent preparation for injection (wash hands, mix medicine)

• Wash your hands thoroughly again. Wipe them with alcohol.
• Also wipe the medicine ampoule with alcohol.
• Shake all the medicine into the wide part of the ampoule.
• Using a nail file, carefully make several cutting movements on the ampoule.
• Open the package with the syringe from the needle side.
• Check whether the needle is firmly attached to the syringe body and whether the cap can be removed.
• Break off the tip of the ampoule with alcohol-soaked cotton wool.
• Place the tip of the ampoule on the prepared plate.
• Without touching the edges of the ampoule, draw up the medicine with a needle.
• If the medicine is in the form of a powder that needs to be diluted, dilute the composition strictly according to the instructions.
• Be sure to wipe the medicine bottle with alcohol before adding the solvent into it.
• Place the ampoule on a plate prepared in advance.
• Cover the needle with a cap, the needle is sterile, and you need to keep it exposed to air as little as possible.
• Shake the syringe, tap it with your finger so that the trapped air rises up
• Release the air bubbles; they need to be squeezed out with a piston through the needle without removing the cap.
• Place the finished syringe on a sterile surface (plate)
• Have another sterile alcohol wipe nearby and unpack it

Moral readiness of the child

Most kids have a negative attitude towards injections. A few tricks can help you give injections to children without tears or scandal. You can invite your baby to play in the hospital, first by performing several non-painful manipulations. You can promise a reward if the baby behaves well during the injection. A very good result is achieved when the child is passionate about something: a cartoon, playing with another parent, with an older brother or sister.

How to correctly - intramuscular injection technique

• Place your baby on his tummy. Bare his buttocks.
• Distract the little one; if the gluteal muscle is relaxed, the injection will be less painful.
• Mentally divide your buttock into four parts.
• Wipe the outer top quarter with an alcohol wipe
• Massage the entire gluteal muscle at the same time, this will distract the child.
• Remove the cap from the needle
• Slightly gather the desired square of the buttock into a fold
• Insert the needle at a 90 degree angle to a depth of more than half the needle
• Slowly press the plunger of the syringe with your thumb
• Apply pressure to the injection site with a sterile alcohol pad and pull out the needle.
• Lightly massage the injection site to help the medicine disperse faster.
• Have pity on the baby
• Don't forget to throw away the remaining ampoule, syringe and napkins.

If you do not have an assistant and you have to do the injection alone, you can use this technique. Having prepared everything for manipulation in advance
her, sit on a chair, placing the child between your legs, facing your left hand. If your baby cannot stand, place him face down on your lap. Squeeze the baby's legs with your knees, press the baby to your knees with the elbow of your left hand, and inject with your right hand. This method, of course, will not please the baby at all, but it will allow you to give the injection alone.

Remember a few more rules:

• It is strictly forbidden to give injections to children with a previously used syringe. Do not store used syringes. Dispose of them by capping the needle tightly.
• Do not use cosmetics or alcohol to wipe the injection site.
• Choose the right syringes and needles. Consult your doctor about which syringe is best for injecting. For babies, the smallest needles are needed, 5 mm long. For older children, from six months to a year, you can use two-millimeter syringes.
• Before removing the medicine from the ampoule with a needle, warm the ampoule with your hands. Warm medicine will cause less pain and be absorbed better.
• Observe the storage conditions for medications. If the medicine is stored longer than prescribed, it is strictly forbidden to give an injection.
• Intramuscular injections for children cannot be given to a shallow depth. This will cause bumps. The medicine will not get into the muscle, but will spread under the skin.
• If you accidentally touch a sterile needle with your hand, or if you drop an ampoule, syringe or needle, throw it away. Inject with a new syringe from a new ampoule. Don't skimp on your own child's health.
• When performing an injection, absolute compliance with hygiene rules is necessary. This will prevent infectious complications.

Be sure to praise your son or daughter after the injection. Try to immediately switch the child’s attention to something positive.

In the life of every mother, it may happen that a correctly administered intramuscular injection can save the child’s life, alleviate suffering, and turn out to be a decisive procedure. Therefore, it is very important to know how togive an injection to a child.

Living in a foreign country, inability to pay for the services of a medical professional, work schedule - a small list of reasons that encourage every mother to learn how to independently and correctly give intramuscular injections to a child. In this case, it is important to follow the instructions exactly.

Intramuscular injection into ass - this is a strong pain and emotional stress for every baby. Therefore, if the disease is at a mild stage and it is possible to change the procedure, talk to your doctor about alternative treatment.

A medicine administered intramuscularly affects the body 3 times faster than a tablet or syrup, works more effectively and does not damage the gastrointestinal tract.

In the event that you need emergency help and time ticks by in minutes, you shouldn’t hesitate or think. It is necessary to act on the lesion, treat the cause and consequences, give an injection in the butt.

What is needed for the injection?

To give an intramuscular injection to a child, you need to buy at the pharmacy:

• medical alcohol or a special antiseptic for intramuscular injections;
• sterile cotton wool;
• a syringe with a needle of the appropriate size;
• the medicine is in the required dosage (you need to check that the expiration date and contents are appropriate).

The needle is selected depending on the age of the patient. For infants under one year old, you need to use syringes with a dosage of 1 ml; for children 1-5 years old, you can purchase 2 ml. And for patients aged 6 to 9 years, it is recommended to purchase needles 0.5x25 or 0.6x30.

How to prepare for the procedure?

Gluteal injection for a childis a micro-intervention in the functioning of a child’s body, which is carried out with the aim of improving the general condition of a small patient. In order not to infect the baby during manipulation, it is important:

1. wash your hands clean;
2. treat them with a special disinfectant solution or alcohol;
3. carefully treat the puncture site before administering the drug and after manipulation.

It is important to remember that young children are very suspicious and fearful. Therefore, in order not to frighten the patient, it is better to do all manipulations not in front of the child.

Before giving a child an injection, moral preparation is important for the mother. You need to understand that by causing pain to the baby for just a few moments, the quality and effectiveness of treatment improves. Therefore, in order for the child to be less hysterical, cry and be afraid, the calm appearance of the mother (the person giving the injection) is most important. Decisiveness, understanding and firmness of action are half the success. The second part of it depends solely on the execution technique.

Another important preparatory point before manipulation is the choice of syringe. For children under 3 years of age, experts recommend using 2-cc syringes with a small and sharp needle. In such syringes the needle is very thin, and therefore less painful. If the baby needs to inject more than 2 cubes of the drug at once, then doctors recommend purchasing separately sterile thin needles.

Older patients need to take syringes with longer needles, since if the drug gets under the skin, a lump or abscess may form.

Important! If the medication is supposed to be taken by breaking the integrity of the rubber stopper, then before giving an injection in the butt, you need to replace the needle with a new one.

How to take medicine?

Before giving an injection to your child, you need to know:

• time of drug administration;
• chemical properties of the substance;
• what to dilute the medicine with. When the injection is dispensed as a powder in a pharmacy, you need to check with a specialist which component needs to be diluted. At the same time, you need to understand that mixing the drugs is carried out directly in the bottle with the powder. To do this, without opening the ampoule, you need to introduce a diluent (ledocaine or a special solution) through a needle, shake well and re-draw the ready-made medicine into the syringe for intramuscular administration.
• Methods for removing air from a syringe. The absence of air when injecting the drug into the thigh is an important point that is strictly prohibited from being ignored. To remove excess air from the syringe, experts recommend turning it upside down with the needle and tapping it a little on the walls. This will cause the bubbles to start moving towards the needle. Then you need to press the piston a little, releasing the remaining air. When the medicine appears at the end of the needle, the air has escaped.

How to mentally prepare a child?

For young children, injections are the biggest punishment, accompanied by pain and fear. And medical vaccination in this case is no exception. You should not deceive your child with stories that everything will happen unnoticed. It’s better to say that it will hurt a little, but your mother will be there to support you through all the experiences. Giving an injection during a child's hysteria is highly undesirable.

You can buy a play set for the doctor in advance and show your child how to give injections to toys, treat them with pills and other methods. This way the baby will see that injections are not a very pleasant treatment, but they are worth being patient for a speedy recovery. After all, what toys take a long time to get sick?

As additional motivation for the child, if there is free money in the family budget, the child can buy a toy, sweets, or a small souvenir. By collecting positive emotions, very soon the child will stop crying, hysterical and will allow him to give injections on his own.

How is the injection given?

To give an injection in the buttock with minimal trauma to the patient, you need to follow a certain sequence:

1. Clear the work surface. Take off your pants (tights) and underwear.
2. Secure the lower limbs. Even if the baby voluntarily lay down on the couch, when the skin is pierced, the leg may reflexively move.
3. Within a minute you can do a light massage of the buttocks. This manipulation will distract the baby and relax the muscles.
4. Conditionally divide the buttock into 4 sectors (square) and select the upper outermost quarter of the buttock for the injection.
5. Disinfect the puncture site. Before giving the injection, you need to generously and thoroughly wipe the area with a cotton swab soaked in alcohol.
6. Clearly, quickly and with a “steady” hand insert the needle and syringe into the designated area.
7. Gradually withdraw the medication from the syringe.
8. Pull out the syringe with the needle and wipe the area with cotton wool soaked in alcohol.

If a needle suddenly breaks during the procedure, you need to immediately call an ambulance!

If a young mother has never given injections before, and now she has to treat her child at home, experts recommend that you familiarize yourself with how to doinjections in the buttocks of children on video.Thus, for most parents, the fear of performing manipulation and awareness of the need for the procedure become understandable.

How else to prepare your baby for vaccination?

It's no secret that vaccinations should only be done in a clinic. In this case, panic, crying and tears from children simply cannot be avoided. In order to make the child as positive as possible about the procedure, it is important to explain the essence of the manipulation and the reason.

Often, to get rid of tension in immunology rooms there are toys and bright pictures. They serve as an excellent distraction to put the baby into the desired position and vaccinate as painlessly as possible.

After a successful injection, be sure to praise the child, tell him how proud you are and how much you admire his courage.

In conclusion, it should be noted that only the right approach and competent execution of the manipulation can guarantee success. Do not intimidate, deceive a child, or instill fear of medical personnel. The absence of fear and confidence in the support of loved ones will be real helpers of effective treatment.