The history of various injections is closely related to the creation and improvement of the syringe. Along with it, the technology of injecting medications developed. For several centuries, humanity has tried to accomplish this using improvised means - straws, hollow bird feathers.
The modern version of the syringe appeared only in the 19th century. Since then, injection of drugs has been widely used in medicine. Now there is not a single patient in whose treatment injections of drugs would not be used.
Intravenous
The needle is inserted directly into the lumen of the vein. Medicines immediately penetrate the bloodstream and have an effect. In terms of technique, this is one of the most difficult types of injections, since you need to get into a blood vessel without piercing it through. In addition, no infection or air bubbles should enter the vein. Intravenous injections are made using a syringe or transfusion systems. Slow infusion through droppers with a catheter allows you to prolong the effect of the drug for several hours and evenly distribute its intake, which is very convenient in the treatment of bedridden patients.
Intravenous injections are done in most cases when it is necessary to quickly release the drug into the blood and begin its action. This is an indispensable first aid tool. But it should be borne in mind that intravascular administration has a greater number of possible complications than subcutaneous and intramuscular administration. Thromboembolism, infection, hematomas in the puncture area, burns and inflammation of the vein walls, etc. occur. Performing intravascular infusions for people without medical education is prohibited.
Intramuscular
Inserting a needle into the thickness of the muscles is an intramuscular injection. The muscles are well supplied with blood and lymph, so the bioavailability of the administered substances is high. The effect of drugs administered in this way occurs much more slowly than with intravenous infusion; usually the effect becomes noticeable after 30-45 minutes. A drug injected into a muscle is kept there for some time in the form of a kind of depot, from where it gradually enters the blood and has an effect on the body.
Intramuscular injections are used in cases where immediate action is not needed, but a daily or multi-hour dose of the drug must be administered so that it is slowly absorbed (for example, the administration of antibiotics). In terms of technique, injections into the muscle are the simplest, but if the technique is incorrect, complications are also possible: getting into large vessels, nerve trunks, infection.
Recormon solution for intravenous and subcutaneous administration 30000 IU 0.6 ml
Treatment of anemia in patients with chronic kidney disease. Subcutaneously or intravenously (within 2 minutes). For patients on hemodialysis - through an arteriovenous shunt at the end of the dialysis session. For patients not receiving hemodialysis, it is preferable to administer the drug subcutaneously to avoid puncture of peripheral veins. The goal of treatment is a hemoglobin (Hb) level of 100-120 g/l. Hb should not exceed 120 g/l. If Hb increases by more than 20 g/l (1.3 mmol/l) over 4 weeks, the dose of the drug should be reduced. In patients with arterial hypertension, cardiovascular and cerebrovascular diseases, the weekly increase in Hb and its target values should be determined individually, depending on the clinical picture. The patient should be carefully monitored in order to select the minimum dose sufficient to ensure the maximum effect of the drug. Treatment with Recormon is carried out in 2 stages. Correction stage. Subcutaneously - initial dose - 20 IU/kg 3 times a week. If the increase in Hb is insufficient (less than 2.5 g/l per week), the dose can be increased every 4 weeks by 20 IU/kg 3 times a week. The total weekly dose of the drug can also be divided into daily administrations. Intravenously - initial dose - 40 IU/kg 3 times a week. If there is insufficient increase in Hb after a month, the dose can be increased to 80 IU/kg 3 times a week. If necessary, in the future the dose should be increased by 20 IU/kg 3 times a week, at monthly intervals. Regardless of the route of administration, the maximum dose should not exceed 720 IU/kg per week. Maintenance therapy. To maintain the target Hb value (100-120 g/l), the dose should first be reduced by 2 times from the previous one. Subsequently, the maintenance dose is selected individually, at intervals of 2 or 4 weeks. When administered subcutaneously, the weekly dose can be administered in one dose or divided into 3 or 7 administrations per week. When the condition stabilizes against the background of a single administration per week, you can switch to a single administration at a two-week interval; in this case, an increase in the dose may be necessary. Treatment with Recormon is usually long-term. If necessary, it can be interrupted at any time. Treatment of symptomatic anemia in patients with solid and hematological non-myeloid tumors receiving chemotherapy. The drug is administered subcutaneously at an initial dose of 30,000 IU per week (450 IU/kg per week), a single dose or a weekly dose can be divided into 3 or 7 injections. Therapy with Recormon is indicated for Hb ≥110 g/l (6.83 mmol/l). The Hb value should not exceed 130 g/l (8.07 mmol/l). If Hb increases by 10 g/l (0.62 mmol/l) after 4 weeks, therapy should be continued at the same dose. If Hb increases by less than 10 g/l (0.62 mmol/l) after 4 weeks, the dose should be doubled. If there is no increase in Hb by 10 g/l (0.62 mmol/l) after 8 weeks, treatment should be interrupted, because response to therapy with Recormon® is unlikely. Treatment should be continued for 4 weeks after the end of chemotherapy. The maximum dose should not exceed 60,000 IU per week. When the target Hb value for a particular patient is achieved, the dose of the drug should be reduced by 25-50%. To prevent an increase in Hb above 130 g/l, further dose reduction may be required. If Hb increases by more than 20 g/l (1.3 mmol/l) per month, the dose of Recormon should be reduced by 25-50%. Preparing patients for the collection of donor blood for subsequent autohemotransfusion. Intravenously (over 2 minutes) or subcutaneously, 2 times a week for 4 weeks. In cases where the patient's hematocrit (? 33%) allows blood sampling, Recormon should be administered at the end of the procedure. Throughout the course of treatment, the hematocrit should not exceed 48%. The dose of the drug is determined by the transfusiologist and the surgeon individually, depending on the volume of blood that will be taken from the patient and his erythrocyte reserve: 1. The volume of blood that will be taken from the patient depends on the expected blood loss and available blood preservation techniques and the general condition of the patient; it must be sufficient to avoid a blood transfusion from another donor. 2. The volume of blood that will be taken from the patient is expressed in units (one unit is equivalent to 180 ml of red blood cells). 3. The possibility of donation depends mainly on the blood volume of a given patient and the initial hematocrit. Both indicators determine the endogenous erythrocyte reserve, which is calculated using the following formula: Endogenous erythrocyte reserve = blood volume [ml] x (hematocrit - 33): 100 Women: blood volume [ml] = 41 [ml/kg] x body weight [kg] + 1200 [ml] Men: blood volume [ml] = 44 [ml/kg] x body weight [kg] + 1600 [ml] (with body weight ? 45 kg). The indication for use of the drug Recormon and its single dose are determined by nomograms, based on the required volume of donor blood and endogenous erythrocyte reserve. The maximum dose should not exceed 1600 IU/kg per week when administered intravenously and 1200 IU/kg per week when administered subcutaneously. Prevention of anemia in premature newborns. Subcutaneously, 250 IU/kg 3 times a week, as early as possible, preferably from the 3rd day of life, for 6 weeks. Dosing in special patient groups. Children and teenagers. In children and adolescents, the dose of the drug depends on age: as a rule, the younger the age, the higher doses of Recormon are required. But, since it is impossible to predict the individual response to the drug, it is advisable to start with a standard dosage regimen. When treating anemia associated with chronic kidney disease, Recormon should not be prescribed to children under 2 years of age. Elderly age. In clinical studies, the need for dose changes was not determined. Mode of application. The syringe tube with Recormon is ready for use. The solution it contains is sterile and does not contain preservatives. Only a light, transparent or slightly opalescent solution that does not contain visible inclusions should be used. If after the injection a certain amount of the drug remains in the syringe tube, repeated administration is unacceptable.
Subcutaneous
For hypodermic injections, the needle is inserted to a depth of no more than 15 mm. The drug enters the layer of subcutaneous fat. Small amounts of drugs (up to 2 ml) can be administered in this way. Before the injection, the skin is gathered into a fold, then a needle is inserted into this fold at an angle of 45 and the liquid is slowly released. The optimal places to perform it are the space under the shoulder blades, the anterior side of the thigh, the outer part of the shoulder, the lower part of the armpit, that is, all places where it is easy to make a skin fold.
Subcutaneous injections are used in cases where there is no immediate need for the onset of action of the drug, but it is desirable to bypass the gastrointestinal tract. In addition, there are medications that are destroyed in the gastrointestinal tract or are poorly absorbed in it. Subcutaneous injections are simple in technique, and in case of an error they give even fewer complications than intramuscular ones. Therefore, subcutaneous injections are allowed for people without medical education. Possible complications include infection and hematoma at the injection site. Subcutaneous administration is often used for vaccination.
Indications
By injection, those medications are administered that are not absorbed in the intestinal wall, cause local irritation, or quickly disintegrate under the influence of enzymes of the digestive tract.
Intradermal administration is used for allergy tests, as well as specific diagnostic reactions - Mantoux, Pirquet, etc. Subcutaneous injections are used when it is necessary to ensure prolonged absorption and effect of the drug (insulin, heparin, vaccines).
Intradermal
Introducing drugs into the skin is not so simple technically and requires some skill. A thin needle should penetrate only under the upper stratum corneum, but not into the subcutaneous fat. A sign that the injection has been performed correctly is a light-colored bump with the drug that appears on the skin after injection. After some time it resolves.
Intradermal administration of drugs is most often used in cosmetology to normalize the condition of the skin, as well as when testing for allergens and specific immune reactions (Mantoux test, Schick reaction, etc.). Some types of local anesthesia are also administered this way. As a rule, they are done on the outer surface of the shoulder and forearm. It is prohibited for non-specialists (people without medical training) to perform such injections.
What are intradermal, subcutaneous, and intramuscular injections used for?
Injection is a method of introducing medications into body tissues in the form of solutions using syringes and hollow needles. Recently, another method of injecting drugs has been used - high-pressure injection using needle-free devices. There are several types of injections:
- Intradermal. When placing them, the needle is inserted into the thickness of the skin to a slight depth at an acute angle. The solution, penetrating into the tissue, forms a round elevation - a “lemon peel”. The following sites are used for intradermal injection: the middle and upper third of the anterior outer area of the shoulder, the middle and upper third of the anterior outer area of the thigh. Less commonly used are the lateral area of the anterior abdominal wall, the area around the navel, and the subscapular area.
- Subcutaneous. They are placed by puncturing the skin about 15 millimeters deep. The rapid effect of the drug with this type of parenteral administration is explained by the fact that there are many blood vessels in the subcutaneous fat layer. Medicines here are quickly absorbed and do not cause any harm to the subcutaneous tissue. Up to two liters of liquid can be injected under the skin. The most convenient areas of the human body for subcutaneous injections are considered to be: the outer surface of the shoulder, the subscapular area, the anterior outer area of the thigh, and the anterolateral area of the abdomen. When carrying out manipulations, the location of large vessels and nerves should be avoided.
- Intramuscular. During this manipulation, a puncture is most often made in the area of the upper outer quadrant of the gluteal region. Somewhat less frequently, the area of the outer surface of the thigh or the posterolateral surface of the shoulder is used. The volume of injected solution with a standard intramuscular injection does not exceed six milliliters.
- Intravenous. The drugs are administered into superficially located and inactive ulnar and radial veins. Less commonly, puncture of venous vessels is performed in the dorsum of the hand.
The injections are carried out by specially trained medical personnel. The manipulation is carried out in a procedural setting on an outpatient basis or in a hospital in compliance with the principles of asepsis and antisepsis.
Rules for injections to prevent complications
Almost all complications can be prevented by maintaining sterility and avoiding air bubbles in the liquid. After opening, you must not touch the needle; the injection site must be treated with cotton wool and alcohol. Use only sterile preparations from ampoules.
Air bubbles from the liquid must be carefully removed because when they enter the blood, they cause the formation of a blood clot. This complication is especially dangerous with intra-arterial injections, and slightly less so with intravenous injections.
In our clinic, injections are performed by qualified specialists, come and perform the procedures without the risk of complications!
CLINIC PRICES OUR CLINIC DOCTORS MAKE AN APPOINTMENT ASK QUESTIONS PERMANENT DISCOUNTS PROMOTIONS THIS MONTH
Order of conduct
Before administering a drug, you should definitely check your sensitivity to this medication. The manipulation is carried out in a procedural environment, maintaining sterility. Treat the surface of your hands with alcohol using two cotton balls.
The skin is pre-treated twice in the injection area. To do this, use sterile beads with alcohol. First, a large area of skin around is captured. Then it is treated only at the puncture site. Injections are performed as follows:
- Intradermal administration. Take half a milliliter of the drug from the ampoule with a long needle. Then change the regular needle to a thin one. Check its patency. For injection, use the middle third of the patient's forearm, its inner surface. Hold the needle with the cut side up. It is inserted at an acute angle parallel to the skin. Then the end of the needle is inserted into the tissue to hide the gap. After this, 0.1 ml of solution is injected. A papule forms, which resolves after forty minutes. The needle is removed and the skin is not treated after the injection.
- Subcutaneous. With your left hand, collect the skin into a fold. Right, hold the syringe at an acute angle. Then the needle is inserted to a depth of approximately 2/3 of its length. The cut is directed upward. The drug is administered. A cotton swab with alcohol is applied to the puncture site. With a sharp movement, remove the needle from the tissue. Massage the injection site with a cotton ball and alcohol for better distribution.
- Intramuscular. Determine the exact injection site on the buttock. The injection is made into the upper-outer sector at an angle of 90° to the surface. With the left hand, the soft tissues are firmly fixed. With the right hand, insert the needle perpendicular to the surface to a depth of six centimeters. Slowly introduce the solution. Remove the needle with a quick movement, applying a cotton ball with alcohol to it. The injection site is lightly massaged.
After administering medications, it is necessary to monitor the injection sites. The formation of infiltrates and suppurations should be avoided.
