Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

IV therapy and Medication Administration

Catherine Cabrera

Clinical Supervisor

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10 Rights of Drug Administration

Right patient

Right drug

Right dose

Right time

Right route

Right to refuse

Right to assessment

Right to evaluation

Right to health education

Right documentation

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Knowing all drug administration protocols is essential.

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

PPE

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Treat all blood and body fluids as potentially infectious.

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Needle Handling Precautions

Dispose sharps in a sharps container.

“Fish Hook” when recapping.

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Medication Administration and Documentation

Record all information concerning the patient and medication

Example:

0800H Cefuroxime 250mg via IV push given ANST.

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PERCUTANEOUS DRUG administration is drugs applied to and absorbed through

the skin or mucous membranes.

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Transdermal

Absorbed through the skin at a slow, steady rate

Example:Topical OintmentSprayIntradermal

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

Sublingual Medication Administration

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

Buccal Medication Administration

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

Eye Drop Administration

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Nasal Medication Administration

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Manually open the ear canal and administer the appropriate dose.

Aural Medication Administration

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Pulmonary Drug Administration

Medications are administered into the pulmonary system via inhalation or injection.

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Metered dose inhaler

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Endotracheal Tube

Several medications can be administered through an endotracheal tube

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Enteral Drug Administration

The delivery of any medication that is absorbed through the gastrointestinal tract

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Gastrointestinal tract

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

1. 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.

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2. Gastric Tube Administration

Gastric tubes provide access directly to the GI system.

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Confirm proper tube placement.

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

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

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Instill the medication into the gastric tube.

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Gently inject the saline.

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Clamp off the distal tube.

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

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.

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Parenteral Drug Administration

Drug administration outside of the gastrointestinal tract.

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Syringes and Needles

Syringe Hypodermic needle

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AmpulesVials

Ampules and Vials

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Information on Drug Labels

Name of medication

Expiration date

Total dose and concentration

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Obtaining Medication from a Glass Ampule

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

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

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Place gauze around the thin neck…

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

…and snap it off with your thumb.

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Draw up the medication.

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Obtaining Medicationfrom a Vial

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Confirm the vial label.

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Prepare the syringe and hypodermic needle.

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Cleanse the vial’s rubber top.

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Insert the hypodermic needle into the rubber top and inject the air

from the syringe into the vial.

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Nonconstituted drugs come in separate vials. Confirm the labels.

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Remove all solution from the vial containing the mixing solution.

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

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Agitate or shake the vialto ensure complete mixture.

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Prepare a new syringe and hypodermic needle.

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Withdraw the appropriate volume of medication.

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Parenteral Routes

Intradermal injection

Subcutaneous injection

Intramuscular injection

Intravenous access

Intraosseous infusion

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Intradermal Injection

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Assemble and preparethe needed equipment.

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Check the medication.

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Draw up the medication.

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Prepare the administration site.

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Pull the patient’s skin taut.

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

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

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Monitor the patient.

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Subcutaneous Injection

45º

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Subcutaneous Injection Sites

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Prepare the equipment.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Check the medication.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Draw up the medication.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Prep the site.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Insert the needle at a 45-degree angle.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Remove the needle and cover the puncture site.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Monitor the patient.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Intramuscular Injection Sites

Deltoid

Dorsal gluteal

Vastus lateralis

Rectus femoris

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Intramuscular Injection

90º

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Intramuscular Injection Sites

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Prepare the equipment.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Check the medication.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Draw up the medication.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Prepare the site.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Insert the needle at a 90-degree angle.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Remove the needle and cover the puncture site.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Monitor the patient.

© Scott Metcalfe

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Summary

10 Rights

Medication Administration Routes

Medication Package

Anatomy and Physiology related to Medication Administration

Bledsoe et al., Essentials of Paramedic Care: Division 1© 2006 by Pearson Education, Inc. Upper Saddle River, NJ

Questions?