Name: selecting sites for intramuscular injections
Uploaded: 2017-02-14T16:09:18.000Z
Duration: 12 min 28 s
Channel: JoVE

<ol>
	<li>Institute of Medicine. To Err is Human: Building a Safer Healthcare System. Academic Press. Washington, DC. (2000).</li>
	<li>Centers for Disease Control and Prevention. http://www.cdc.gov/. (2017).</li>
</ol>

В этом видео демонстрируется приготовление и введение внутримышечных препаратов. В соответствии с передовой практикой, для иммунизации в дельтовидную мышцу следует вводить препараты для внутримышечного введения, а также препараты в дозе менее 1 мл, но не более 2 мл. Большие объемы (т.е. более 2 мл, но менее 3 мл) должны вводиться в вентроглюдиальную мышцу; Этот участок используется для приема антибиотиков. Распространенные ошибки при введении внутримышечных препаратов включают введение больших объемов в дельтовидную мышцу или использование ягодичной мышцы, в результате чего лекарство и игла попадают на нерв, кость или жировую ткань. Еще одной распространенной ошибкой является использование игл большой длины у пациентов с небольшим количеством мышечной ткани, что также увеличивает вероятность попадания в костную ткань и возникновения остеомиелита. Как и при любой инъекции, неспособность создать натянутую поверхность и колебания с инъекцией могут привести к загрязнению кончика иглы, а повторное закрытие использованной иглы может привести к травме от укола иглой. Поэтому всегда следует строго придерживаться практики безопасного использования игл.

Подготовка и введение внутримышечных инъекций

Preparing and Administering Intramuscular Injections

Источник: Мадлен Ласше, MSNEd, RN и Кэти Бараки, MSN, RN, Колледж медсестер, Университет штата Юта, UT
При внутримышечных (ВМ) инъекциях лекарства вводятся глубоко в мышечную ткань. Поскольку мышечные волокна хорошо перфузируются, такой способ введения обеспечивает быстрое усвоение лекарства и позволяет вводить относительно большие объемы. Скелетные мышцы имеют меньше чувствительных к боли нервов, чем подкожная клетчатка, что позволяет менее болезненно вводить раздражающие препараты (например, хлорпромазин, антипсихотик). Внутримышечные инъекции рекомендуются пациентам, которые не могут принимать пероральные препараты, а также пациентам, отказывающимся от приема. Некоторые примеры лекарств, которые обычно доставляются с помощью внутримышечных инъекций, включают антибиотики, гормоны и вакцинацию.
Как и при любом другом способе введения, медсестра должна решить, подходит ли лекарство, учитывая состояние здоровья пациента, аллергию и текущее клиническое состояние. Кроме того, конкретно для внутримышечных инъекций важно оценить мышечную массу пациента, чтобы определить подходящий размер иглы. Также, если пациент уже получал эту инъекцию, необходимо проверить место инъекции, которое использовалось ранее, и убедиться, что предыдущая доза не привела к каким-либо побочным реакциям.
Места, которые чаще всего используются для внутримышечных инъекций, включают дельтовидную мышцу плеча; широкая широкая широта бедра; и вентроягодичные, средние ягодичные или дорсоглютеиновые мышцы бедра. Лучше всего избегать введения внутримышечных инъекций в дорсоягодичную мышцу, потому что это место связано с повышенным риском попадания в кровеносный сосуд, нерв или кость.
В этом видео мы сосредоточимся на основных шагах, которые должна выполнить каждая медсестра, чтобы правильно подготовить и ввести внутримышечную инъекцию.

Source: Madeline Lassche, MSNEd, RN and Katie Baraki, MSN, RN, College of Nursing, University of Utah, UT
Intramuscular (IM) injections deposit ...

preparing-and-administering-intramuscular-injections

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selecting sites for intramuscular injections

Intramuscular injections place medication deep into muscle tissue. Because muscle has a rich blood supply, this route can move medication into the body quickly and can handle relatively large volumes. Skeletal muscle also has fewer pain-sensing nerves than subcutaneous tissue, which can make it a better choice for irritating drugs such as chlorpromazine.

IM injections are often used when a patient cannot take medicine by mouth or is not cooperative. Common examples include antibiotics, hormones, and vaccinations. Before giving an IM injection, the nurse must check whether the medication is right for the patient based on medical conditions, allergies, and current clinical status.

Site choice is also important for IM injections. The nurse should assess muscle mass to help choose the correct needle size. If the patient has received the injection before, the previous site should be confirmed, and the nurse should make sure the earlier dose did not cause an adverse reaction.

Common IM sites include the deltoid muscle in the shoulder, the vastus lateralis in the thigh, and the ventrogluteal, gluteus medius, or dorsogluteal muscles in the hip. The dorsogluteal site is usually avoided because it carries a higher risk of hitting a blood vessel, nerve, or bone. The video focuses on the essential steps nurses follow to prepare and give an IM injection correctly.

Selecting Sites for Intramuscular Injections

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nursing skills

This collection demonstrates medication preparation and administration, with videos highlighting important safety checks, considerations, dosage calculations, and common mistakes associated with improper medication administration.

Learn how intramuscular injections work, when they are used, and how nurses choose safe IM sites, needle size, and medication checks.

Selecting Sites for Intramuscular Injections

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